Ethical health resources allocation: Why the distinction between ‘rationing’ and ‘rationalization’ matters

Abstract

Allocation of health resources has an irreducible ethical dimension, thus cannot be decided only technically, but must be ethically weighed, what paradigmatic experiences of macro (Oregon Basic Health Services Act, 1989) and micro allocation (God’s Committee, 1962) have shown. Justice is required in the enunciation of prioritization criteria, and transparency in its application. In situations of aggravated resource scarcity, it is common to take ‘allocate’ and ‘rationing’ as synonyms or claim that ‘allocate’ is always ‘rationing’. Rejecting these positions, there is a distinction between 'allocating' (resource management) from 'rationing' (allocation of limited resources to a limited number of persons) and 'rationalizing' (optimization of available resources). These distinctions are ethically pertinent, showing how only 'rationalization' respects justice, transparency and human dignity.

Keywords

• allocation
• rationing
• rationalization
• justice
• transparency
• human dignity