Allocating healthcare resources on the basis of personal responsibility for ill-health: what role (if any) should public opinion play? A socio-ethical analysis

The suggestion that individual responsibility for ill-health, and consequent healthcare need, should be a factor in healthcare priority-setting is increasingly debated. The adoption of such a principle within UK healthcare distribution policy would be both socially and ethically contentious. This study examines the concept of a 'responsibility principle' within healthcare priority-setting and explores the contribution of the views, values and preferences of the public to the ongoing discussions. The ethical justification for seeking public participation in this type of debate is explored. Within this thesis, a range of issues are critically evaluated, including healthcare distribution via the 'QALY' approach, the incorporation of distributional weighting of health benefits and the influence of social values on healthcare provision. It is concluded that an enhanced public contribution could be attained by systematically investigating how members of the public reason and construct ethical arguments regarding 'responsibility' as a priority-setting principle and that such an investigation would demand a clear, empirically-based and ethically-sound methodological approach. The means by which this may be accomplished is investigated, and a conceptual and practical basis for eliciting and examining the ethical reasoning and arguments of members of the public is presented in a detailed proposal that represents an innovative approach to research in this area. A range of socio-ethical issues inform this study, including social value judgements, placing limits on what may be perceived to be socially justified entitlements, and questions of the citizen's role in contributing to ethically important social policy. The study employs a conceptual approach to these issues and identifies, evaluates and applies ethical arguments to the relevant topics. This study contributes to both methodological and empirical knowledge regarding public participation in healthcare debates and assists the interpretation of existing evidence of the public's views in this area.

Name dc:type.qualificationname

mphil

Level dc:type.qualificationlevel

doctoral

Grantor dc:publisher.institution

University of East Anglia

Year dc:date.issued

2013

Author dc:creator

• Chaloner, Christopher

Language dc:language

en