A research report submitted to the Faculty of Humanities, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Arts in Applied Ethics For Professionals, July 2017 / Health and, by extension, healthcare is accepted to be a valuable and important social good that is both a good
in and of itself, as well as necessary to achieve life’s goals. Its fair distribution is therefore properly the subject
of ethical concern and in the era of modern medicine where costs and potentially limitless treatments exceed
available resources, rationing healthcare has become an unavoidable necessity. Since such rationing implies
that not everyone’s needs or preferences can be met, a fair and just way of rationing healthcare is a widely
debated and controversial topic that, to date, remains unresolved. Where third-party private funding
organisations are tasked with these rationing responsibilities, the ethical complexities are compounded by
perceived conflicts between the ethical frameworks that govern corporate organisations versus those that
govern healthcare. Given the apparent inability of normative theories to resolve the problem of how to ration
healthcare fairly, there has been a shift in thinking to considerations of procedural justice and a dominant
model, Accountability for Reasonableness (AFR), has emerged as the favoured procedure for healthcare
decision-making. The report shows why health is an important social value and examines the key models and
principles that dominate the rationing debate as well as why the conflict between healthcare ethics and
organisational ethics create additional complexities that must be considered when making these funding
decisions. Furthermore it explores the rationales for resorting to procedural accounts with specific emphasis on
the parameters and validity of AFR. The report concludes that even though the AFR framework may be a
legitimate and just process that can effectively frame decision-making and provide a platform to drive
transparency and consistency, like most procedural accounts, it does not guarantee that the outcomes it
produces are necessarily fair or just. Therefore a straightforward application of AFR cannot resolve the
healthcare rationing debate which should, given its ethical complexity, continue to appeal to the important
ethical principles that currently govern the field. / XL2018
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/24529 |
| Date | January 2017 |
| Creators | Cazes, Aerelle Liëtte |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | Online resource (70 leaves), application/pdf, application/pdf |
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