Acceptable health and priority weighting: Discussing a reference-level approach using sufficientarian reasoning

Area of Science:

• Health Economics
• Bioethics
• Public Health Policy

Background:

• Healthcare systems face challenges in allocating scarce resources to meet all health needs.
• The 'acceptable health' approach prioritizes health benefits for individuals with unacceptable health states over those with acceptable states.
• Existing research validates public ability to define acceptable/unacceptable health, but normative implications require further exploration.

Purpose of the Study:

• To address the gap in understanding the normative implications of the 'acceptable health' approach in healthcare priority setting.
• To connect insights from distributive justice, specifically sufficientarianism, with the 'acceptable health' framework.
• To analyze the moral implications of using an 'acceptability' criterion for weighting health benefits.

Main Methods:

• Relating distributive justice (sufficientarianism) to the 'acceptable health' approach.
• Analyzing the normative implications of defining 'acceptable' and 'unacceptable' health states.
• Examining the moral basis for priority weighting of health benefits derived from sufficientarian reasoning.

Main Results:

• The 'acceptable health' approach can be theoretically grounded in sufficientarian principles of distributive justice.
• Evaluating health benefits relative to an acceptability threshold has significant moral implications for resource allocation.
• Sufficientarianism provides a framework for understanding why prioritizing 'unacceptable' health states is morally justifiable.

Conclusions:

• The 'acceptable health' approach, when informed by sufficientarianism, offers a robust ethical framework for healthcare resource allocation.
• This approach supports prioritizing interventions that move individuals from unacceptable to acceptable health states.
• Further research should explore empirical validation and practical implementation of this ethically-grounded priority-setting mechanism.