Publicity and pricelessness: grassroots decisionmaking and justice in rationing.
The "grassroots turn" in bioethical discussions about justice in allocation of health care resources has attracted a great deal of support; in the absence of a convincing theory of justice in rationing, democratic decisionmaking concerning priority setting emerges with a kind of inevitability. Yet there remain suspicions about this approach--most importantly, worries about the socially corrosive impact of explicit, public decisionmaking that in effect sets a price on the lives of persons. These worries have been quieted, particularly by the work of Leonard Fleck, but not altogether stilled. I explore more sympathetically the ideals to which concerns about public rationing somewhat dimly respond, and suggest constraints on priority setting discussions which might accommodate those ideals rather better.
Nelson
J L
JL
Hastings Center, Briarcliff Manor, NY 10510.
D003256:Community Participation; D003657:Decision Making; D015276:Health Care Rationing / Q000191:economics / Q000331:legislation & jurisprudence / Q000592:standards*; D006801:Humans; D009922:Oregon; D011057:Politics; D040841:Resource Allocation; D012935:Social Justice; D012945:Social Values; D013221:State Health Plans; D014481:United States; D026712:Value of Life