TY - JOUR
T1 - Principles for allocation of scarce medical interventions
AU - Persad, Govind
AU - Wertheimer, Alan
AU - Emanuel, Ezekiel J.
PY - 2009
Y1 - 2009
N2 - Allocation of very scarce medical interventions such as organs and vaccines is a persistent ethical challenge. We evaluate eight simple allocation principles that can be classified into four categories: treating people equally, favouring the worst-off, maximising total benefits, and promoting and rewarding social usefulness. No single principle is sufficient to incorporate all morally relevant considerations and therefore individual principles must be combined into multiprinciple allocation systems. We evaluate three systems: the United Network for Organ Sharing points systems, quality-adjusted life-years, and disability-adjusted life-years. We recommend an alternative system-the complete lives system-which prioritises younger people who have not yet lived a complete life, and also incorporates prognosis, save the most lives, lottery, and instrumental value principles.
AB - Allocation of very scarce medical interventions such as organs and vaccines is a persistent ethical challenge. We evaluate eight simple allocation principles that can be classified into four categories: treating people equally, favouring the worst-off, maximising total benefits, and promoting and rewarding social usefulness. No single principle is sufficient to incorporate all morally relevant considerations and therefore individual principles must be combined into multiprinciple allocation systems. We evaluate three systems: the United Network for Organ Sharing points systems, quality-adjusted life-years, and disability-adjusted life-years. We recommend an alternative system-the complete lives system-which prioritises younger people who have not yet lived a complete life, and also incorporates prognosis, save the most lives, lottery, and instrumental value principles.
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U2 - 10.1016/S0140-6736(09)60137-9
DO - 10.1016/S0140-6736(09)60137-9
M3 - Review article
C2 - 19186274
AN - SCOPUS:58749109650
SN - 0140-6736
VL - 373
SP - 423
EP - 431
JO - The Lancet
JF - The Lancet
IS - 9661
ER -