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Setting Limits FairlyCan we learn to share medical resources?$
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Norman Daniels and James E. Sabin

Print publication date: 2002

Print ISBN-13: 9780195149364

Published to Oxford Scholarship Online: September 2009

DOI: 10.1093/acprof:oso/9780195149364.001.0001

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Accountability for Reasonableness

Accountability for Reasonableness

Setting Limits Fairly

Norman Daniels

James E. Sabin

Oxford University Press

This chapter describes the conditions that must be met in order for both private organizations, such as health plans, and public agencies to be accepted as legitimate moral authorities for distributing health care fairly. It argues for four conditions that make more precise the notion of accountability for reasonableness: publicity condition, relevance condition, revision and appeals condition, and regulative condition. The four conditions compel decision makers in health plans or public agencies to contribute their deliberative capacities to whatever broader public deliberation is conducted through democratic institutions, formally or informally. The arrangements required by the four conditions provide grist for the deliberative mill, not a replacement for broader democratic processes. Ultimately, these broader democratic processes have authority and responsibility for guaranteeing the fairness of limit-setting decisions.

Keywords:   health care, deliberation, publicity condition, relevance condition, dispute resolution, regulative condition

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