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15 - Allocating resources in humanitarian medicine

Published online by Cambridge University Press:  01 March 2011

By
Samia A. Hurst ,
Nathalie Mezger  and
Alex Mauron
Edited by
Solomon Benatar  and
Gillian Brock
Solomon Benatar
Affiliation:
University of Cape Town
Gillian Brock
Affiliation:
University of Auckland
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Summary

Background

Allocating resources in humanitarian medicine is a vitally important and cruelly difficult exercise. In the huge disconnect between severe human needs and limited resources, even asking how allocation can be fair can seem harsh. Do those involved in humanitarian medicine not simply do all they can?

Daunting as the questions regarding how to allocate resources fairly and legitimately in humanitarian medicine may be, they are gaining in importance for at least three identifiable and related reasons.

First, one of the primary motivating factors for humanitarian medicine is the rule of rescue, “the imperative people feel to rescue identifiable individuals facing avoidable death,” or other plights invoking a shock or horror reaction, “without thinking about the costs too much” (Jonsen, 1986; McKie & Richardson, 2003). As humanitarian medicine successfully raises awareness of urgent health-related needs in poverty-stricken regions of the world, the number of such identifiable victims increases. Indeed, we should expect identified needs to remain greater than the available means as long as there are both pressingly needy sick persons, and advocates raising awareness to their plight. One usual implication of the rule of rescue is that an identifiable, immediate victim should have priority over distant “statistical” lives. From the perspective of a humanitarian organization, persons in need are indeed identifiable, and giving aid to them is saving real, not “statistical” lives. As the number of such identifiable victims, and the diversity of their needs, increase, so does the complexity of allocation decisions.

Type
Chapter
Information
Global Health and Global Health Ethics , pp. 173 - 183
Publisher: Cambridge University Press
Print publication year: 2011

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References

Arrow, K. J. (2001). Uncertainty and the welfare economics of medical care. 1963. Journal of Health Politics, Policy and Law 26(5), 851–883.CrossRefGoogle ScholarPubMed
Ashcroft, R. (2008). Fair process and the redundancy of bioethics: a polemic. Public Health Ethics 1(1), 3–9.CrossRefGoogle Scholar
Beitz, C. R. (1975). Justice and international relations. Philosophy and Public Affairs 4(4), 360–389.Google Scholar
Beitz, C. R. (2001). Does global inequality matter?Metaphilosophy 32(1/2), 97–112.CrossRefGoogle Scholar
Birch, M. & Miller, S. (2005). Humanitarian assistance: standards, skills, training, and experience. British Medical Journal 330(7501), 1199–1201.CrossRefGoogle ScholarPubMed
Buchanan, A. (1999). The internal legitimacy of humanitarian intervention. Journal of Political Philosophy 7(1), 71–87.CrossRefGoogle Scholar
Calmy, A., Klement, E., Teck, R. et al. (2004). Simplifying and adapting antiretroviral treatment in resource-poor settings: a necessary step to scaling-up. Aids 18, 2353–2360.Google ScholarPubMed
Caney, S. (2001). Cosmopolitan justice and equalizing opportunities. Metaphilosophy 32(1/2), 113–134.CrossRefGoogle Scholar
Coulter, A. & Ham, C. (2000). The Global Challenge of Health Care Rationing. Buckingham: Open University Press.Google Scholar
Daniels, N. (1985). Just Health Care. New York: Cambridge University Press.CrossRefGoogle ScholarPubMed
Daniels, N. (1994). Four unsolved rationing problems. A challenge. Hastings Center Report 24(4), 27–29.CrossRefGoogle ScholarPubMed
Daniels, N. & Sabin, J. (1997). Limits to health care: fair procedures, democratic deliberation, and the legitimacy problem for insurers. Philosophy and Public Affairs 26(4), 303–350.CrossRefGoogle ScholarPubMed
Diallo, D. A., Doumbo, O. K., Plowe, C. V. et al. (2005). Community permission for medical research in developing countries. Clinical Infectious Diseases 41(2), 255–259.CrossRefGoogle ScholarPubMed
Dyer, O. (2004). Bush accused of blocking access to cheap AIDS drugs. British Medical Journal 328, 783.Google ScholarPubMed
Forst, R. (2001). Towards a Critical Theory of Transnational Justice. Metaphilosophy 32(1/2), 160–179.CrossRefGoogle Scholar
Fuller, L. (2006). Justified commitments? Considering resource allocation and fairness in Médecins Sans Frontières-Holland. Developing World Bioethics 6(2), 59–70.CrossRefGoogle ScholarPubMed
Harding-Pink, D. (2004). Humanitarian medicine: up the garden path and down the slippery slope. British Medical Journal 329(7462), 398–399.CrossRefGoogle ScholarPubMed
Hendrickson, D. (1998). Humanitarian action in protracted crisis: an overview of the debates and dilemmas. Disasters 22(4), 283–287.CrossRefGoogle ScholarPubMed
Hendriks, A. & Toebes, B. (1998). Towards a universal definition of the right to health?Medical Law 17(3), 319–332.Google ScholarPubMed
Hinsch, W. (2001). Global distributive justice. Metaphilosophy 32(1/2), 58–78.CrossRefGoogle Scholar
Hurst, S. A. & Danis, M. (2007). A framework for rationing by clinical judgment. Kennedy Institute of Ethics Journal 17(3), 247–266.CrossRefGoogle ScholarPubMed
Jonsen, A. R. (1986). Bentham in a box: technology assessment and health care allocation. Law, Medicine and Health Care 14(3–4), 172–174.CrossRefGoogle Scholar
Katz, A. (2004). The Sachs report: Investing in health for economic development – or increasing the size of the crumbs from the rich man's table? Part I. International Journal of Health Services 34(4), 751–773.CrossRefGoogle ScholarPubMed
Laurent, C., Kouanfack, C., Koulla-Shiro, S. et al. (2004). Effectiveness and safety of a generic fixed-dose combination of nevirapine, stavudine, and lamivudine in HIV-1-infected adults in Cameroon: open-label multicentre trial. Lancet 364(9428), 29–34.CrossRefGoogle ScholarPubMed
Macklin, R. (2003). Ethics and equity in access to HIV treatment: “3 by 5”initiative. www.who.int/ethics/en/background-macklin.pdf.
McIntyre, A. (1994). Guilty bystanders? On the legitimacy of duty to rescue statutes. Philosophy and Public Affairs 23, 157–191.CrossRefGoogle Scholar
McKie, J. & Richardson, J. (2003). The rule of rescue. Social Science and Medicine 56(12), 2407–2419.CrossRefGoogle ScholarPubMed
Michael, M. & Zwi, A. B. (2002). Oceans of need in the desert: ethical issues identified while researching humanitarian agency response in Afghanistan. Developing World Bioethics 2(2), 109–130.CrossRefGoogle ScholarPubMed
Murphy, L. B. (2000). Moral Demands in Non-ideal Theory. Oxford:Oxford University Press.Google Scholar
Nagel, T. (2005). The problem of global justice. Philosophy and Public Affairs 33(2), 113–147.CrossRefGoogle Scholar
O'Neill, O. (2001). Agents of justice. Metaphilosophy 32(1/2), 181–195.CrossRefGoogle Scholar
Palmer, C. A. (1999). Rapid appraisal of needs in reproductive health care in southern Sudan: qualitative study. British Medical Journal 319(7212), 743–748.CrossRefGoogle ScholarPubMed
Pogge, T. W. (2002). Responsibilities for poverty-related ill health. Ethics and International Affairs 16(2), 71–79.CrossRefGoogle ScholarPubMed
Pogge, T. W. (2005). Real World Justice. Journal of Ethics 9, 29–53.CrossRefGoogle Scholar
Redmond, A. D. (2005). Needs assessment of humanitarian crises. British Medical Journal 330(7503), 1320–1322.CrossRefGoogle ScholarPubMed
Rougemont, A. (1995). From humanitarian action to international health. Soz Praventivmed 40(1), 3–10.CrossRefGoogle ScholarPubMed
Scheffler, S. (1992). Human Morality. Oxford: Oxford University Press.Google Scholar
,United Nations (1948). Universal Declaration of Human Rights, Article 25. 2007. www.un.org/Overview/rights.html.
Wikler, D. (2003). Why prioritize when there isn't enough money?Cost Effective Resource Allocation 1(1), 5.CrossRefGoogle ScholarPubMed

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