Can Rationing Through Inconvenience Be Ethical?

48 Hastings Center Report, Jan.-Feb. 2018, at 10

Arizona Legal Studies Discussion Paper No. 19-03

14 Pages Posted: 23 Mar 2019

See all articles by Nir Eyal

Nir Eyal

Harvard University - T.H. Chan School of Public Health

Paul L. Romain

Harvard University - Beth Israel Deaconess Medical Center

Christopher T. Robertson

University of Arizona - James E. Rogers College of Law; Harvard University - Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics

Date Written: 2018

Abstract

n this article, we provide a comprehensive analysis and a normative assessment of rationing through inconvenience as a form of rationing. By “rationing through inconvenience” in the health sphere, we refer to a non-financial burden (the inconvenience) that is either intended to cause or has the effect of causing patients or clinicians to choose an option for health‐related consumption that is preferred by the health system for its fairness, efficiency, or other distributive desiderata beyond assisting the immediate patient. We argue that under certain conditions, rationing through inconvenience may turn out to serve as a legitimate and, compared to direct rationing, even a preferable tool for rationing; we propose a research agenda to identify more precisely when that might be the case and when, alternatively, rationing through inconvenience remains ethically undesirable. After defining and illustrating rationing through inconvenience, we turn to its moral advantages and disadvantages over other rationing methods.

We take it as a starting assumption that rationing, understood as scarce‐resource prioritization, is inevitable and, in a society that has goals beyond optimizing health care for individual patients—such as improving societal health care, education, or overall welfare—prudent and fair.

Keywords: health care, rationing through inconvenience, prioritization, ethics, morality

Suggested Citation

Eyal, Nir and Romain, Paul L. and Robertson, Christopher T., Can Rationing Through Inconvenience Be Ethical? (2018). 48 Hastings Center Report, Jan.-Feb. 2018, at 10 ; Arizona Legal Studies Discussion Paper No. 19-03. Available at SSRN: https://ssrn.com/abstract=3358604

Nir Eyal

Harvard University - T.H. Chan School of Public Health ( email )

677 Huntington Avenue
Boston, MA MA 02115
United States

Paul L. Romain

Harvard University - Beth Israel Deaconess Medical Center ( email )

330 Brookline Avenue
Boston, MA 02115
United States

Christopher T. Robertson (Contact Author)

University of Arizona - James E. Rogers College of Law ( email )

P.O. Box 210176
Tucson, AZ 85721-0176
United States

HOME PAGE: http://www.law.arizona.edu/faculty/getprofile.cfm?facultyid=714

Harvard University - Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics ( email )

23 Everett Street
Cambridge, MA 02155
United States

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