Can Rationing through Inconvenience Be Ethical?

Nir Eyal, Paul L. Romain, Christopher Robertson

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

In this article, we provide a comprehensive analysis and a normative assessment of rationing through inconvenience as a form of rationing. By “rationing through inconvenience” in the health sphere, we refer to a nonfinancial burden (the inconvenience) that is either intended to cause or has the effect of causing patients or clinicians to choose an option for health-related consumption that is preferred by the health system for its fairness, efficiency, or other distributive desiderata beyond assisting the immediate patient. We argue that under certain conditions, rationing through inconvenience may turn out to serve as a legitimate and, compared to direct rationing, even a preferable tool for rationing; we propose a research agenda to identify more precisely when that might be the case and when, alternatively, rationing through inconvenience remains ethically undesirable. After defining and illustrating rationing through inconvenience, we turn to its moral advantages and disadvantages over other rationing methods. We take it as a starting assumption that rationing, understood as scarce-resource prioritization, is inevitable and, in a society that has goals beyond optimizing health care for individual patients—such as improving societal health care, education, or overall welfare—prudent and fair.

Original languageEnglish (US)
Pages (from-to)10-22
Number of pages13
JournalHastings Center Report
Volume48
Issue number1
DOIs
StatePublished - Jan 1 2018

Fingerprint

rationing
Health
Delivery of Health Care
Health Education
Research
health
Rationing
health care
fairness
efficiency

ASJC Scopus subject areas

  • Health(social science)
  • Issues, ethics and legal aspects
  • Philosophy
  • Health Policy

Cite this

Can Rationing through Inconvenience Be Ethical? / Eyal, Nir; Romain, Paul L.; Robertson, Christopher.

In: Hastings Center Report, Vol. 48, No. 1, 01.01.2018, p. 10-22.

Research output: Contribution to journalArticle

Eyal, Nir ; Romain, Paul L. ; Robertson, Christopher. / Can Rationing through Inconvenience Be Ethical?. In: Hastings Center Report. 2018 ; Vol. 48, No. 1. pp. 10-22.
@article{e37ec4168f6f4131ba1463ef5d219b33,
title = "Can Rationing through Inconvenience Be Ethical?",
abstract = "In this article, we provide a comprehensive analysis and a normative assessment of rationing through inconvenience as a form of rationing. By “rationing through inconvenience” in the health sphere, we refer to a nonfinancial burden (the inconvenience) that is either intended to cause or has the effect of causing patients or clinicians to choose an option for health-related consumption that is preferred by the health system for its fairness, efficiency, or other distributive desiderata beyond assisting the immediate patient. We argue that under certain conditions, rationing through inconvenience may turn out to serve as a legitimate and, compared to direct rationing, even a preferable tool for rationing; we propose a research agenda to identify more precisely when that might be the case and when, alternatively, rationing through inconvenience remains ethically undesirable. After defining and illustrating rationing through inconvenience, we turn to its moral advantages and disadvantages over other rationing methods. We take it as a starting assumption that rationing, understood as scarce-resource prioritization, is inevitable and, in a society that has goals beyond optimizing health care for individual patients—such as improving societal health care, education, or overall welfare—prudent and fair.",
author = "Nir Eyal and Romain, {Paul L.} and Christopher Robertson",
year = "2018",
month = "1",
day = "1",
doi = "10.1002/hast.806",
language = "English (US)",
volume = "48",
pages = "10--22",
journal = "Hastings Center Report",
issn = "0093-0334",
publisher = "Hastings Center",
number = "1",

}

TY - JOUR

T1 - Can Rationing through Inconvenience Be Ethical?

AU - Eyal, Nir

AU - Romain, Paul L.

AU - Robertson, Christopher

PY - 2018/1/1

Y1 - 2018/1/1

N2 - In this article, we provide a comprehensive analysis and a normative assessment of rationing through inconvenience as a form of rationing. By “rationing through inconvenience” in the health sphere, we refer to a nonfinancial burden (the inconvenience) that is either intended to cause or has the effect of causing patients or clinicians to choose an option for health-related consumption that is preferred by the health system for its fairness, efficiency, or other distributive desiderata beyond assisting the immediate patient. We argue that under certain conditions, rationing through inconvenience may turn out to serve as a legitimate and, compared to direct rationing, even a preferable tool for rationing; we propose a research agenda to identify more precisely when that might be the case and when, alternatively, rationing through inconvenience remains ethically undesirable. After defining and illustrating rationing through inconvenience, we turn to its moral advantages and disadvantages over other rationing methods. We take it as a starting assumption that rationing, understood as scarce-resource prioritization, is inevitable and, in a society that has goals beyond optimizing health care for individual patients—such as improving societal health care, education, or overall welfare—prudent and fair.

AB - In this article, we provide a comprehensive analysis and a normative assessment of rationing through inconvenience as a form of rationing. By “rationing through inconvenience” in the health sphere, we refer to a nonfinancial burden (the inconvenience) that is either intended to cause or has the effect of causing patients or clinicians to choose an option for health-related consumption that is preferred by the health system for its fairness, efficiency, or other distributive desiderata beyond assisting the immediate patient. We argue that under certain conditions, rationing through inconvenience may turn out to serve as a legitimate and, compared to direct rationing, even a preferable tool for rationing; we propose a research agenda to identify more precisely when that might be the case and when, alternatively, rationing through inconvenience remains ethically undesirable. After defining and illustrating rationing through inconvenience, we turn to its moral advantages and disadvantages over other rationing methods. We take it as a starting assumption that rationing, understood as scarce-resource prioritization, is inevitable and, in a society that has goals beyond optimizing health care for individual patients—such as improving societal health care, education, or overall welfare—prudent and fair.

UR - http://www.scopus.com/inward/record.url?scp=85042218793&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85042218793&partnerID=8YFLogxK

U2 - 10.1002/hast.806

DO - 10.1002/hast.806

M3 - Article

C2 - 29457241

AN - SCOPUS:85042218793

VL - 48

SP - 10

EP - 22

JO - Hastings Center Report

JF - Hastings Center Report

SN - 0093-0334

IS - 1

ER -