Preparing popular views for inclusion in a reflective equilibrium: A case study on illness severity

Area of Science:

• Bioethics
• Health Policy
• Moral Philosophy

Background:

• Healthcare priority setting principles are often expert-driven.
• Implementation faces challenges from democratic and political factors, leading to rejection of expert proposals.
• There's a tension between expert-derived principles and public moral judgments.

Purpose of the Study:

• To explore the inclusion of popular views in reflective equilibrium processes for healthcare priority setting.
• To develop a method for refining popular views to meet the standard of considered judgments.
• To enhance the normative soundness and public acceptability of priority setting principles.

Main Methods:

• Examined the inclusion of popular views in reflective equilibrium.
• Proposed bolstering popular views by linking them with theoretical frameworks.
• Used illness severity as a case study to demonstrate the method's applicability.

Main Results:

• Popular accounts, when bolstered, can yield considered judgments.
• These considered judgments are suitable for inclusion in publicly informed reflective equilibrium.
• The proposed method offers a framework for refining popular moral views.

Conclusions:

• A method exists to integrate public moral judgments into healthcare priority setting.
• This approach can lead to principles that are both ethically robust and publicly accepted.
• The framework is applicable even when the consideredness of popular views cannot be directly assessed.