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Reflective disequilibrium : A critical evaluation of the complete lives framework for healthcare rationing
Symons, Xavier
Symons, Xavier
Author
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.
Keywords
Date
2021
Type
Journal article
Journal
Journal of Medical Ethics
Book
Volume
47
Issue
2
Page Range
108-112
Article Number
ACU Department
Plunkett Centre for Ethics
Faculty of Theology and Philosophy
Faculty of Theology and Philosophy
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Open Access Status
License
All rights reserved
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Controlled