Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-22T19:54:36.110Z Has data issue: false hasContentIssue false

Microlevel Prioritizations and Incommensurability

Published online by Cambridge University Press:  07 December 2017

Abstract:

This article addresses the prioritization questions that arise when people attempt to institutionalize reasonable ethical principles and create guidelines for microlevel decisions. I propose that this instantiates an incommensurability problem, and suggest two different kinds of practical solutions for dealing with this issue.

Type
Special Section: Open Forum
Copyright
Copyright © Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Notes

1. Bærøe, K. Priority setting in health care: On the relation between reasonable choices on the micro-level and the macro-level. Theoretical Medicine and Bioethics 2008;29:87102;CrossRefGoogle ScholarPubMed Sheunemann, L, White, DB. The ethics and reality of rationing in medicine. Chest 2012;140:1625–32.CrossRefGoogle Scholar

2. Parfit, D. On What Matters. Oxford: Oxford University Press; 2011;Google Scholar Scanlon, T. What We Owe to Each Other. Cambridge, MA: Harvard University Press; 1998.Google Scholar

3. Chang, R. Comparativism: The grounds of rational choice. In: Lord, E, McGuire, B, eds. Weighing Reasons. Oxford: Oxford University Press; 2015.Google ScholarPubMed

4. Eyal, N, Hurst, SA, Norheim, OF, Wikler, D. Introduction: What’s wrong with health inequalities? In: Eyal, N, Hurst, SA, Norheim, OF, Wikler, D, eds. Inequalities in Health. Concepts, Measures, and Ethics. Oxford: Oxford University Press; 2013;CrossRefGoogle Scholar Robinson, S, Dickinson, H, Williams, I, Freeman, T, Rumbold, B, Spence, K. Setting Priorities in Health. London: Nuffield Trust; 2011;Google Scholar Sabik, LM, Lie, RK. Priority setting in health care: Lessons from the experiences of eight countries. International Journal for Equity in Health 2008;7:4.CrossRefGoogle ScholarPubMed

5. Hausman, DM. Valuing Health: Well-Being, Freedom, and Suffering. Oxford: Oxford University Press; 2015.CrossRefGoogle Scholar

6. Bognar, G, Hirose, I. The Ethics of Health Care Rationing. New York: Routledge; 2014;Google Scholar see note 5, Hausman 2015; Sassi, F. Calculating QALYs, comparing QALY and DALY calculations. Health Policy and Planning 2006;21:402–8.CrossRefGoogle ScholarPubMed

7. Cookson, R, Dolan, P. Principles of justice in health care rationing. Journal of Medical Ethics 2000;26:323–9;CrossRefGoogle ScholarPubMed Crisp, R. Treatment according to need: Justice and the British National Health Service. In: Rosamond, R, Battin, MP, Silvers, M, eds. Medicine and Social Justice: Essays on the Distribution of Health Care. New York: Oxford University Press; 2002;Google Scholar Herlitz, A, Horan, D. Measuring needs for priority setting in healthcare planning and policy. Social Science and Medicine 2016;157:96102;CrossRefGoogle ScholarPubMed Juth, N. Challenges for principles of need in health care. Health Care Analysis 2015;23:7387.CrossRefGoogle ScholarPubMed

8. See note 7, Herlitz, Horan 2016.

9. Ross, WD. The Right and the Good. Oxford: Oxford University Press; 2002.CrossRefGoogle Scholar

10. Kagan, S. The additive fallacy. Ethics. 1988;99:531.CrossRefGoogle Scholar

11. Davidson, D. On the very idea of a conceptual scheme. Proceedings and Addresses of the American Philosophical Association 1973;47:520;CrossRefGoogle Scholar Kuhn, T. The Structure of Scientific Revolutions, 3rd ed. Chicago: Chicago University Press; 1996.CrossRefGoogle Scholar

12. Raz, J. The Morality of Freedom. Oxford: Clarendon Press; 1986.Google Scholar

13. Chang, R. Introduction. In: Chang, R, ed. Incommensurability, Incomparability, and Practical Reason. Cambridge, MA: Harvard University Press; 1997;Google Scholar Temkin, L. Rethinking the Good: Moral Ideals and the Nature of Practical Reasoning. Oxford: Oxford University Press; 2012.CrossRefGoogle Scholar

14. Broome, J. Is incommensurability vagueness? In: Chang, R, ed. Incommensurability, Incomparability, and Practical Reason. Cambridge, MA: Harvard University Press; 1997.Google Scholar

15. Chang, R. The possibility of parity. Ethics 2002;112:659–88.CrossRefGoogle Scholar

16. Herlitz, A. The limited impact of indeterminacy for healthcare rationing: How indeterminacy problems show the need for a hybrid theory, but nothing more. Journal of Medical Ethics 2016;42:22–5.CrossRefGoogle ScholarPubMed

17. See note 13, Chang 1997.

18. Anderson, E. Value in Ethics and Economics. Cambridge, MA: Harvard University Press; 1993; see note 12, Raz 1986.Google Scholar

19. See note 5, Hausman 2015; Sen A. Development as Freedom. Oxford: Oxford University Press; 1999.

20. Chang, R. Grounding practical normativity: Going hybrid. Philosophical Studies 2013;164:163–87;CrossRefGoogle Scholar Korsgaard, C. Self-Constitution: Agency, Identity, and Integrity. Oxford: Oxford University Press; 2009.CrossRefGoogle Scholar

21. Aristotle (trans. Pakaluk M.). Nicomachean Ethics. Oxford: Clarendon Press; 1998.

22. Nagel T. The fragmentation of values. In: Nagel T. Mortal Questions. Cambridge: Cambridge University Press; 1979; see note 13, Temkin 2012.