[Can rationing be fair? Ethical considerations regarding justice in the healthcare system]

While economy tries to solve the problem of scarcity by rationing, i.e. increasing efficiency, ethics reflect the path of the just distribution of scarce goods, necessarily including the means of transparent and fair rationing. But how can such rationing be realised in a healthcare system? Non-medical criteria such as the patient's social function or age, though vividly discussed, are inappropriate. Only medical criteria can bring sustainable solutions. The QALY and DALY models are such an attempt. Careful reflection of these measures of quality of life and, in some aspects, accompanying rules to avoid extreme unfairness will be critical to their success.