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.