Distributive justice in health-care – why should severity of ill health matter? (JUST SEVERITY)

The concept of severity of ill health plays an essential role for distributive justice in health-care, voicing documented intuitions.

The issue of how to distribute scarce resource between different patient groups is becoming even more pressing, given demographic changes, the medico-technical development and high expectations from citizens.

Despite the essential role for severity as a tool for distributive justice, it has recently been observed that it is a undertheorized and contested concept, with an unclear normative rationale and thereby conflicting use.The aim is to develop a normatively robust conceptualization of severity as a central part of principles for healthcare distributions.This aim is fleshed out in an overarching research question: What is the most plausible normative rationale for severity of ill health as a central part of principles for healthcare distributions?The research question will be answered by using an empirical ethics approach in 4 work packages.

In WP1 normative analysis is used to arrive at different models for severity drawing on general theories of distributive justice. In WP2, health-economical modelling is used to explore the effect on resource and health distribution of these models. In WP3, the models undergo legal analyses in relation to national and international law.

In the final work package a synthesis to arrive at the most normatively plausible conceptualization is made.