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Indeterminacy and the principle of need
1Department of Philosophy, Linguistics and Theory of Science, University of Gothenburg, Box 100, 405 30, Gothenburg, Sweden. andersherlitz@gmail.com.
Theoretical Medicine and Bioethics
|January 2, 2017
Summary
The principle of need in healthcare resource allocation is inherently indeterminate. Addressing this requires careful consideration of strategies like adding principles, enforcing determinacy, or empowering decision-makers.
Area of Science:
- Health Economics
- Bioethics
- Public Health Policy
Background:
- The principle of need is central to healthcare priority setting.
- Resource allocation decisions often invoke the concept of need.
Purpose of the Study:
- To argue that a reasonable principle of need must be indeterminate.
- To examine strategies for managing this indeterminacy in healthcare priority setting.
Main Methods:
- Conceptualizing need as a composite property (health shortfall and capacity to benefit).
- Applying the small improvement argument to illustrate indeterminacy.
- Analyzing three strategies: appendicizing, imposing determinacy, and empowering decision-makers.
Main Results:
- Need is a composite property where factors can relate indeterminately.
- The small improvement argument demonstrates this indeterminacy.
- All examined strategies for managing indeterminacy have significant shortcomings.
Conclusions:
- Indeterminacy is a key characteristic of the principle of need in healthcare.
- Further research is needed to effectively manage this indeterminacy.
- Integrating the principle of need within a plurality of priority-setting principles is a promising avenue.
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