Abstract
Abstract models and theoretical concepts related to health-care priority setting are of little use to us in the absence of a real-world context where they can be applied. Continuing on the work by Heiner Raspe from Chap. 7, this chapter outlines seven lessons learned from the initiatives of explicit or open priority setting undertaken in the State of Oregon in the United States and in Sweden. These real-world experiences of explicit priority setting also serve as practical examples of approaches that have, from the outset, emphasized two opposing views on distributive fairness, maximizing health benefit within the population versus giving priority to those with the greatest need.
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Notes
- 1.
Child and palliative care offer an example of two different interpretations of who is the worst off. Children are worst off in the sense that they have not had their fair share of a full life, and palliative patients are worst off in the sense of severity of illness.
- 2.
For example, it makes little sense to screen men for breast cancer. Hence, in that case, gender becomes a medically relevant personal characteristic.
- 3.
However, when allocating vaccine against swine flu, the rule of human dignity was abandoned, and priority was given to individuals “important to the functioning of society as a whole.” This further illustrates that the principle of human dignity tends to be more of a symbolic gesture than anything else.
- 4.
If it is assumed that the needs principle does not incorporate capacity to benefit.
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Tinghög, G. (2016). Health-Care Priority Setting in Practice: Seven Unresolved Problems. In: Nagel, E., Lauerer, M. (eds) Prioritization in Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-21112-1_8
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