Fair Chances

Abstract

AbstractThis chapter examines the “fair chances” objection to cost-effective allocation—that it is unfair to allocate health care to those who can most benefit from health care before doing anything to treat those who would benefit substantially but not as much. The chapter first provides this criticism with a philosophical foundation in Broome’s theory of fairness, but it challenges Broome’s theory and it raises questions about whether the fair chances objection has much force. The chapter develops a hypothetical case that brings out implications of the fair chances objection, and suggests further qualms concerning Broome’s theory. The chapter concludes by considering how moral concerns that are separate from fairness and enhancing health bear on the assessment of cost-effectiveness.