Reflective disequilibrium : A critical evaluation of the complete lives framework for healthcare rationing
Journal article
Symons, Xavier. (2021). Reflective disequilibrium : A critical evaluation of the complete lives framework for healthcare rationing. Journal of Medical Ethics. 47(2), pp. 108-112. https://doi.org/10.1136/medethics-2020-106626
Authors | Symons, Xavier |
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Abstract | One prominent view in recent literature on resource allocation is Persad, Emanuel and Wertheimer’s complete lives framework for the rationing of lifesaving healthcare interventions (CLF). CLF states that we should prioritise the needs of individuals who have had less opportunity to experience the events that characterise a complete life. Persad et al argue that their system is the product of a successful process of reflective equilibrium—a philosophical methodology whereby theories, principles and considered judgements are balanced with each other and revised until we achieve an acceptable coherence between our various beliefs. Yet I argue that many of the principles and intuitions underpinning CLF conflict with each other, and that Persad et al have failed to achieve an acceptable coherence between them. I focus on three tensions in particular: the conflict between the youngest first principle and Persad et al’s investment refinement; the conflict between current medical need and a concern for lifetime equality; and the tension between adopting an objective measure of complete lives and accommodating for differences in life narratives. |
Year | 2021 |
Journal | Journal of Medical Ethics |
Journal citation | 47 (2), pp. 108-112 |
Publisher | BMJ Publishing Group |
ISSN | 0306-6800 |
Digital Object Identifier (DOI) | https://doi.org/10.1136/medethics-2020-106626 |
Scopus EID | 2-s2.0-85102933128 |
Research or scholarly | Research |
Page range | 108-112 |
Publisher's version | License All rights reserved File Access Level Controlled |
Output status | Published |
Publication dates | |
Online | 17 Dec 2020 |
Publication process dates | |
Accepted | 28 Oct 2020 |
Deposited | 01 Jul 2022 |
https://acuresearchbank.acu.edu.au/item/8xz74/reflective-disequilibrium-a-critical-evaluation-of-the-complete-lives-framework-for-healthcare-rationing
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