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Health Care Analysis

, Volume 11, Issue 4, pp 325–343 | Cite as

Justice and Solidarity in Priority Setting in Health Care

  • Rogeer Hoedemaekers
  • Wim Dekkers
Article

Abstract

During the last decade a “technical” approach has become increasingly influential in health care priority setting. The various country reports illustrate, however, that non-technical considerations cannot be avoided. As they often remain implicit in health care package decisions, this paper aims to make these normative judgements an explicit part of the procedure. More specifically, it aims to integrate different models of distributive justice as well as the principle of solidarity in four different phases of a decision-making procedure, and to identify important moral choices which present themselves. First four important justice models are discussed, then a justification is given for their inclusion in a four-step decision making procedure. This is followed by a discussion of different justice and solidarity problems—with their inherent conceptual difficulties in each of these stages. The paper concludes with a summary of the major moral choices that are to be made in health care package decisions.

choices in health care justice solidarity utilitarianism egalitarianism communitarianism health technology assessment quality of life 

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Copyright information

© Kluwer Academic Publishers 2003

Authors and Affiliations

  • Rogeer Hoedemaekers
    • 1
  • Wim Dekkers
    • 1
  1. 1.Department of Ethics, Philosophy and History of MedicineUniversity Medical CentreNijmegenThe Netherlands

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