Health, priority to the worse off, and time

Abstract

It is a common view that benefits to the worse off should be given priority when health benefits are distributed. This paper addresses how to understand who is worse off in this context when individuals are differently well off at different times. The paper argues that the view that this judgment about who is worse off should be based solely on how well off individuals are when their complete lives are considered (i.e. ‘the complete lives view’) is implausible in this context. Instead, it is argued that a pluralistic stance toward this issue should be accepted. This pluralistic stance recognizes that also the view that only focuses on how well off individuals are now and in the future (i.e. ‘the forward-looking view’) is relevant. The argument is based on appeals to intuitive judgments concerning who is worse off in different cases and reference to various underlying reasons why priority to benefits to the worse off is justified.

Setting Health-Care Priorities: What Ethical Theories Tell Us, Torbjörn Tännsjö. Oxford University Press, 2019, xii + 212 pages.

“…Furthermore, Temkin has a radically different view of what the rationale behind egalitarianism is (he thinks it is an impersonal ideal; Temkin 2003), and it is not at all obvious that the rationale behind egalitarianism is separateness and integrity of persons. Moreover, there is an ongoing debate among egalitarians regarding how to account for inequalities at specific times, and it is far from obvious that egalitarians would give as strong priority to young people as Tännsjö assumes (Segall 2016;Herlitz 2018aHerlitz , 2018b. As a matter of fact, Temkin explicitly dismisses the view that egalitarians should care only about distributions across entire lives (Temkin 1993: Ch.…”