title: Accountability for reasonableness: the relevance, or not, of exceptionality in resource allocation.
abstract: Accountability for Reasonableness has gained international acceptance as a framework to assist with resource allocation within healthcare. Despite this, one of the four conditions, the relevance condition, has not been widely adopted. In this paper I will start by examining the relevance condition, and the constraints placed on it by Daniels and Sabin. Following this, I review the theoretical limitations of the condition identified to date, by prominent critics such as Rid, Friedman, Lauridsen and Lippert-Rasmussen. Finally, I respond to Daniels and Sabin's enthusiasm for testing the accountability for reasonableness framework in different contexts, by evaluating the challenges of implementing the relevance condition within the NHS. I use the funding of treatments for patients on the basis of their exceptional circumstances as a case study to examine whether the relevance condition could be applied in practice.
authors.affiliation: School of Law, University of Manchester, Williamson Building, Oxford Road, Manchester, M13 9PL, UK, Amyford@nhs.net.
authors.forename: Amy
authors.initials: A
authors.lastname: Ford
mesh_terms: D003657:Decision Making; D015276:Health Care Rationing / Q000941:ethics / Q000458:organization & administration*; D006292:Health Priorities / Q000458:organization & administration*; D006801:Humans; D010686:Philosophy, Medical; D013222:State Medicine / Q000458:organization & administration*