Limits to Health Care: Fair Procedures, Democratic Deliberation, and the Legitimacy Problem for Insurers

Daniels, Norman; Sabin, James E.

doi:10.1111/j.1088-4963.1997.tb00082.x

Cited by 501 publications

(268 citation statements)

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“…Many of the decision processes considered in this study can be explored with reference to Daniels and Sabin's Accountability for Reasonableness (A4R) framework (Daniels and Sabin, 1997). Under the relevance criterion, all sites included combinations of evidence in the form of research data, prevalence and cost statistics to inform the priority-setting process.…”

Section: "If We Can't Have Discussion With the Public And Staff Aboumentioning

confidence: 99%

“…The literature identifies a diverse range of challenges for local priority-setting processes including: the design and implementation of models and processes; the application of evidence and decision analysis tools; wider engagement and involvement; and leadership (Dickinson et al, 2011;Daniels and Sabin, 1997;Ham & Roberts, 2003;Klein & Williams, 2000;Sabik and Lie, 2008;Williams et al 2012;). These are briefly summarised here and returned to in the light of findings from the study.…”

Section: Introductionmentioning

confidence: 99%

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Priority-setting and rationing in healthcare: Evidence from the English experience

Robinson

Williams

Dickinson

et al. 2012

Social Science & Medicine

149

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Section: "If We Can't Have Discussion With the Public And Staff Aboumentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Priority-setting and rationing in healthcare: Evidence from the English experience

Robinson

Williams

Dickinson

et al. 2012

Social Science & Medicine

149

View full text Add to dashboard Cite

“…Setting limits in health care tends to evoke strong feelings of injustice among citizens. Since justice plays a major role in all social relations, it is commonly alleged to be essential that people perceive the process (Daniels & Sabin 1997) or the outcome (Beauchamp & Childress 1994) related to limit setting as fair.…”

Section: Introductionmentioning

confidence: 99%

It takes a giraffe to see the big picture – Citizens' view on decision makers in health care rationing

Broqvist

Garpenby

2015

Social Science & Medicine

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Previous studies show that citizens usually prefer physicians as decision makers for rationing in health care, while politicians are downgraded. The findings are far from clear-cut due to methodological differences, and as the results are context sensitive they cannot easily be transferred between countries. Drawing on methodological experiences from previous research, this paper aims to identify and describe different ways Swedish citizens understand and experience decision makers for rationing in health care, exclusively on the programme level. We intend to address several challenges that arise when studying citizens' views on rationing by (a) using a method that allows for reflection, (b) using the respondents' nomination of decision makers, and (c) clearly identifying the rationing level. We used phenomenography, a qualitative method for studying variations and changes in perceiving phenomena. Open-ended interviews were conducted with 14 Swedish citizens selected by standard criteria (e.g. age) and by their attitude towards rationing.The main finding was that respondents viewed politicians as more legitimate decision makers in contrast to the results in most other studies. Interestingly, physicians, politicians, and citizens were all associated with some kind of risk related to self-interest in relation to rationing. A collaborative solution for decision making was preferred where the views of different actors were considered important. The fact that politicians were seen as appropriate decision makers could be explained by several factors: the respondents' new insights about necessary trade-offs at the programme level, awareness of the importance of an overview of different health care needs, awareness about self-interest among different categories of decision-makers, including physicians, and the national context of long-term political accountability for health care in Sweden. This study points to the importance of being aware of contextual and methodological issues in relation to research on how citizens experience arrangements for rationing in health care.

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“…The context of exploitation and the damage caused by a breach of integrity justify the differentiated and positive treatment of sectors affected by vulnerability, thus prohibiting discriminatory barriers to redressing the effects of inequalities. This includes, in addition to health care, the provision of public education and other interventions to generate opportunities beginning from early childhood 38 .…”

Section: Discussionmentioning

confidence: 99%

“…It corresponds to one of the aspects of the responsibility -personal, political and social -to act in the promotion of health, considered as the fundamental right of every human being, through various actions shared with all sectors. It is the recognition that the states of health of individuals are the result of a social project that depends on the commitment of all, according to their possibilities 1,38 .…”

Section: Discussionmentioning

confidence: 99%

Conceitos de vulnerabilidade humana e integridade individual para a bioética

Morais

Monteiro

2017

Rev. Bioét.

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This article consists of a literature review of the meanings and concepts of vulnerability and integrity contained in the most significant international documents on bioethics, and aims to describe the categories most commonly used to classify vulnerabilities. Technological advances and the increase in clinical research studies in the 20 th century have given rise to new forms of vulnerability, and have emphasized the vulnerabilities caused by social, political and environmental determinants, or in other words, social vulnerability. The intervention bioethics can be used by peripheral countries to address the problem of social exclusion through the use of prudence, prevention, precaution and protection. Latin American bioethics have been important for the expansion and politicization of moral conflicts in health care, allowing the construction of a global bioethics, in which vulnerability can be tackled by adding different perspectives to solve common problems. Keywords: Bioethics. Ethical relativism. Principle-based ethics. Health vulnerability. Social vulnerability. Resumo Conceitos de vulnerabilidade humana e integridade individual para a bioéticaEste artigo consiste em revisão bibliográfica dos significados e conceitos de vulnerabilidade e integridade nos documentos internacionais mais significativos para a bioética. Também é objetivo deste artigo apresentar as categorias de classificação de vulnerabilidades mais utilizadas. Avanços tecnológicos e a multiplicação de pesquisas clínicas no século XX suscitaram novas formas de vulnerabilidade e deixaram mais evidentes aquelas causadas por determinantes sociais, políticos e ambientais, isto é, a vulnerabilidade social. A bioética de intervenção é proposta que pode ser utilizada por países periféricos para enfrentar o problema dos excluídos sociais mediante prudência, prevenção, precaução e proteção. A bioética latino-americana foi importante para ampliar a compreensão sobre conflitos morais em saúde e gerar politização, possibilitando a construção de uma bioética global, na qual a vulnerabilidade pode ser trabalhada agregando diferentes perspectivas para enfrentar problemas comuns. Palavras-chave: Bioética. Relativismo ético. Ética baseada em princípios. Vulnerabilidade em saúde. Vulnerabilidade social. Resumen Los conceptos de vulnerabilidad humana y la Integridad individual para la bioéticaEste artículo consiste en una revisión bibliográfica de los significados y conceptos de vulnerabilidad e integridad en los documentos internacionales más importantes para la bioética. También este artículo tiene como objetivo presentar las categorías de clasificación de vulnerabilidad más utilizadas. Los avances tecnológicos y la multiplicacion de la investigacion clínica en el siglo XX plantearon nuevas formas de vulnerabilidad e hicieron más evidentes las vulnerabilidades causadas por determinantes sociales, políticos y ambientales, o sea, la vulnerabilidad social. La bioética de intervención es una propuesta que puede ser utilizada por los países periféricos para ...

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Limits to Health Care: Fair Procedures, Democratic Deliberation, and the Legitimacy Problem for Insurers

Cited by 501 publications

References 6 publications

Priority-setting and rationing in healthcare: Evidence from the English experience

Priority-setting and rationing in healthcare: Evidence from the English experience

It takes a giraffe to see the big picture – Citizens' view on decision makers in health care rationing

Conceitos de vulnerabilidade humana e integridade individual para a bioética

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