New Book Outlines Ways to "Fairly" Allocate Medical Resources

Research on decision-making in managed care organizations

In 2002, Norman Daniels, PhD, a Harvard University ethics professor, co-authored the book, Setting Limits Fairly: Can We Learn to Share Medical Resources?, which offers criteria for rationing medical resources fairly.

The co-author was James E. Sabin, MD, a professor of psychiatry at Harvard Medical School and director of the ethics program at Harvard Pilgrim Health Care.

Key Results

Dr. Daniels' work, funded under the Robert Wood Johnson Foundation's (RWJF) Investigator Awards in Health Policy Research program, included the following:

  • He proposed four conditions for fair rationing:
    • Publicity. Decisions and the rationales for decisions must be accessible.
    • Relevance. The grounds for such decisions must be ones that fair-minded people can agree are relevant.
    • Appeals. There must be mechanisms to challenge and resolve limit-setting decisions.
    • Regulation. There must be some form of regulation to ensure that the other conditions are met.
  • Oxford University Press published Setting Limits Fairly: Can We Learn to Share Medical Resources? in 1992.
  • Daniels consulted with the National Committee for Quality Assurance on ways to incorporate accountability for reasonableness into its standards.
  • Daniels collaborated on an article published in Daedalus in 1999.
  • With funding from the Rockefeller Foundation, Daniels assisted four countries (Colombia, Mexico, Pakistan and Thailand) in revising benchmarks for analyzing the fairness of health care reforms.