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
AuthorsSymons, Xavier
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.

Year2021
JournalJournal of Medical Ethics
Journal citation47 (2), pp. 108-112
PublisherBMJ Publishing Group
ISSN0306-6800
Digital Object Identifier (DOI)https://doi.org/10.1136/medethics-2020-106626
Scopus EID2-s2.0-85102933128
Research or scholarlyResearch
Page range108-112
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online17 Dec 2020
Publication process dates
Accepted28 Oct 2020
Deposited01 Jul 2022
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