Health, priority to the worse off, and time.

Area of Science:

• Bioethics
• Health Economics
• Public Health Policy

Background:

• Equitable distribution of health benefits often prioritizes individuals who are worse off.
• Determining who is 'worse off' becomes complex when individuals experience varying levels of well-being throughout their lives.

Purpose of the Study:

• To analyze the concept of 'worse off' in the context of health benefit distribution over an individual's lifespan.
• To evaluate the adequacy of the 'complete lives view' versus a 'forward-looking view' in identifying who is worse off.

Main Methods:

• Philosophical argumentation based on ethical principles.
• Analysis of intuitive judgments regarding individual well-being and disadvantage.
• Examination of justifications for prioritizing benefits to the worse off.

Main Results:

• The 'complete lives view,' which assesses well-being over an entire lifespan, is deemed implausible for determining priority in health benefit distribution.
• A pluralistic approach, incorporating both the 'complete lives view' and the 'forward-looking view' (focusing on present and future well-being), is advocated.

Conclusions:

• A nuanced understanding of 'worse off' is crucial for fair health benefit allocation.
• A pluralistic ethical framework offers a more robust approach to prioritizing benefits for those most in need over time.