Cited by 931Ethics and bioethics in healthcareOrgan Donation and TransplantationHealth Systems, Economic Evaluations, Quality of Life

The DOI matches its Crossref record; 92 of the 92 references it cites were found in a registry or an index.

Principles for allocation of scarce medical interventions

Open access

Persad, Govind, Wertheimer, Alan, Emanuel, Ezekiel J·2009·The Lancet

DOI 10.1016/s0140-6736(09)60137-9

Open this paper in CoChat — free account Open PDF

Abstract

Allocation of very scarce medical interventions such as organs and vaccines is a persistent ethical challenge. We evaluate eight simple allocation principles that can be classified into four categories: treating people equally, favouring the worst-off, maximising total benefits, and promoting and rewarding social usefulness. No single principle is sufficient to incorporate all morally relevant considerations and therefore individual principles must be combined into multiprinciple allocation systems. We evaluate three systems: the United Network for Organ Sharing points systems, quality-adjusted life-years, and disability-adjusted life-years. We recommend an alternative system-the complete lives system-which prioritises younger people who have not yet lived a complete life, and also incorporates prognosis, save the most lives, lottery, and instrumental value principles.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Integrity signals

Registry

Crossref · 10.1016/s0140-6736(09)60137-9

Cites

92 of 92 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Principles of Biomedical Ethics
(2012) · Thieves of Virtue · doi:10.7551/mitpress/9079.003.0009 · Cited by 13,453
Cost-Effectiveness in Health and Medicine
(1996) · doi:10.1093/oso/9780195108248.001.0001 · Cited by 7,193
Principles of biomedical ethics
Horton, J. (2002) · Transactions of the Royal Society of Tropical Medicine and Hygiene · doi:10.1016/s0035-9203(02)90265-8 · Cited by 4,408
Nicomachean Ethics
, A. (2010) · Cited by 3,771
On Economic Inequality
Sen, A. K., & Foster, J. E. (1973) · doi:10.1093/0198281935.001.0001 · Cited by 3,439
What Is the Point of Equality?
Anderson, E. S. (1999) · Ethics · doi:10.1086/233897 · Cited by 3,232
The Law of Peoples
Rawls, J. (1999) · Cited by 2,191
Effect of oestrogen during menopause on risk and age at onset of Alzheimer's disease
Tang, M., Jacobs, D. M., Stern, Y., Marder, K. S., Schofield, P., Gurland, B. J., Andrews, H., & Mayeux, R. P. (1996) · The Lancet · doi:10.1016/s0140-6736(96)03356-9 · Cited by 1,647
Sovereign Virtue: The Theory and Practice of Equality
Moore, W. D. (2001) · Political Science Quarterly · doi:10.2307/2657842 · Cited by 1,646
Type 1 diabetes: new perspectives on disease pathogenesis and treatment
Atkinson, M. A., & Eisenbarth, G. S. (2001) · The Lancet · doi:10.1016/s0140-6736(01)05415-0 · Cited by 1,491

Show all 91 references

Research works printed but not linked: 3

Veatch, 2005, Disaster preparedness and triage, Mount Sinai J Med, 72, 236
Veatch, 2001, Equity in liver allocation: Professor Veatch's reply, Med Ethics, 7
Stein, 2002, The distribution of life-saving medical resources: equality, life expectancy, and choice behind the veil, Soc Philos Policy, 19

Sorted by citations

Fair Allocation of Scarce Medical Resources in the Time of Covid-19
Emanuel, E., Persad, G., Upshur, R. E. G., Thome, B. D. C., Parker, M., Glickman, A., Zhang, C., Boyle, C., Smith, M. J., & Phillips, J. P. (2020) · New England Journal of Medicine · doi:10.1056/nejmsb2005114 · Cited by 3,143
Self-citation
Special considerations in the management of adult patients with acute leukaemias and myeloid neoplasms in the COVID-19 era: recommendations from a panel of international experts
Zeidan, A. M., Boddu, P. C., Patnaik, M. M., Bewersdorf, J. P., Stahl, M. F., Rampal, R. K., Shallis, R. M., Steensma, D. P., Savona, M. R., Sekeres, M. A., et al. (2020) · The Lancet Haematology · doi:10.1016/s2352-3026(20)30205-2 · Cited by 675
The Ethics and Reality of Rationing in Medicine
Scheunemann, L. P., & White, D. B. (2011) · CHEST Journal · doi:10.1378/chest.11-0622 · Cited by 244
Fairly Prioritizing Groups for Access to COVID-19 Vaccines
Persad, G., Peek, M. E., & Emanuel, E. (2020) · JAMA · doi:10.1001/jama.2020.18513 · Cited by 233
Self-citation
From efficacy to equity: Literature review of decision criteria for resource allocation and healthcare decisionmaking
Guindo, L. A., Wagner, M., Baltussen, R. M. P. M., Rindress, D., van Til, J. A., Kind, P., & Goetghebeur, M. M. (2012) · Cost Effectiveness and Resource Allocation · doi:10.1186/1478-7547-10-9 · Cited by 226
A Multistep, Consensus-Based Approach to Organ Allocation in Liver Transplantation: Toward a “Blended Principle Model”
Cillo, U., Burra, P., Mazzaferro, V., Belli, L. S., Pinna, A. D., Spada, M., Costa, A. N., & Toniutto, P. (2015) · American Journal of Transplantation · doi:10.1111/ajt.13408 · Cited by 211
Crisis Standards of Care: A Systems Framework for Catastrophic Disaster Response
(2016) · Military Medicine · doi:10.7205/milmed-d-16-00226 · Cited by 193
Guidance on priority setting in health care (GPS-Health): the inclusion of equity criteria not captured by cost-effectiveness analysis
Norheim, O. F., Baltussen, R. M. P. M., Johri, M., Chisholm, D., Nord, E., Brock, D. W., Carlsson, P., Cookson, R., Daniels, N., Danis, M., et al. (2014) · Cost Effectiveness and Resource Allocation · doi:10.1186/1478-7547-12-18 · Cited by 183
Emergency department triage: an ethical analysis
Aacharya, R. P., Gastmans, C., & Denier, Y. (2011) · BMC Emergency Medicine · doi:10.1186/1471-227x-11-16 · Cited by 173
Ethical Challenges Arising in the COVID-19 Pandemic: An Overview from the Association of Bioethics Program Directors (ABPD) Task Force
McGuire, A., Aulisio, M., Davis, F., Erwin, C. J., Harter, T. D., Jagsi, R., Klitzman, R., Macauley, R. C., Racine, E., Wolf, S., et al. (2020) · American Journal of Bioethics · doi:10.1080/15265161.2020.1764138 · Cited by 134
Research Funding: the Case for a Modified Lottery
Fang, F. C., & Casadevall, A. (2016) · mBio · doi:10.1128/mbio.00422-16 · Cited by 186
A Critical Analysis of the Conceptualization and Measurement of Organizational Justice: Is It Time for Reassessment?
Rupp, D. E., Shapiro, D. L., Folger, R. G., Skarlicki, D. P., & Shao, R. (2017) · Academy of Management Annals · doi:10.5465/annals.2014.0051 · Cited by 186
Improving the Evidence Base for Decision Making During a Pandemic: The Example of 2009 Influenza A/H1N1
Lipsitch, M., Finelli, L., Heffernan, R. T., Leung, G. M., & Redd, S. C. (2011) · Biosecurity and Bioterrorism Biodefense Strategy Practice and Science · doi:10.1089/bsp.2011.0007 · Cited by 143
Social values in health priority setting: a conceptual framework
Clark, S., & Weale, A. (2012) · Journal of Health Organization and Management · doi:10.1108/14777261211238954 · Cited by 141
Allocating scarce intensive care resources during the COVID-19 pandemic: practical challenges to theoretical frameworks
Supady, A., Curtis, J. R., Abrams, D. C., Lorusso, R., Bein, T., Boldt, J., Brown, C. E., Duerschmied, D., Metaxa, V., & Brodie, D. (2021) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(20)30580-4 · Cited by 146
Cost‐effectiveness of intensive care for hospitalized COVID-19 patients: experience from South Africa
Cleary, S., Wilkinson, T., Tamandjou, C. R. T., Docrat, S., & Solanki, G. C. (2021) · BMC Health Services Research · doi:10.1186/s12913-021-06081-4 · Cited by 133
Ethical considerations of experimental interventions in the Ebola outbreak
Rid, A., & Emanuel, E. (2014) · The Lancet · doi:10.1016/s0140-6736(14)61315-5 · Cited by 151
Self-citation
Iranian intensive care unit nurses’ moral distress
Atashzadeh‐Shoorideh, F., Ashktorab, T., & Yaghmaei, F. (2012) · Nursing Ethics · doi:10.1177/0969733012437988 · Cited by 136
Autonomous Driving Ethics: from Trolley Problem to Ethics of Risk
Geisslinger, M., Poszler, F., Betz, J., Lütge, C., & Lienkamp, M. (2021) · Philosophy & Technology · doi:10.1007/s13347-021-00449-4 · Cited by 134
Triage of intensive care patients: identifying agreement and controversy
Sprung, C. L., Danis, M., Iapichino, G., Artigas, A., Kesecioğlu, J., Moreno, R. P., Lippert, A. M., Curtis, J. R., Meale, P., Cohen, S. L., et al. (2013) · Intensive Care Medicine · doi:10.1007/s00134-013-3033-6 · Cited by 125
Decision Making in Older Adults With Cancer
DuMontier, C., Loh, K. P., Soto‐Pérez‐de‐Celis, E., & Dale, W. (2021) · Journal of Clinical Oncology · doi:10.1200/jco.21.00165 · Cited by 125
Away from Trolley Problems and Toward Risk Management
Goodall, N. J. (2016) · Applied Artificial Intelligence · doi:10.1080/08839514.2016.1229922 · Cited by 124
Ethics and Resource Scarcity: ASCO Recommendations for the Oncology Community During the COVID-19 Pandemic
Marron, J. M., Joffe, S., Jagsi, R., Spence, R., & Hlubocky, F. J. (2020) · Journal of Clinical Oncology · doi:10.1200/jco.20.00960 · Cited by 121
COVID-19 pandemic: triage for intensive-care treatment under resource scarcity
Swiss Academy of Medical Sciences (2020) · Swiss Medical Weekly · doi:10.4414/smw.2020.20229 · Cited by 113
Coronavirus Disease 2019: Withdrawing Mechanical Ventilation to Reallocate Life Support Under Crisis Standards of Care—Nonequivalence of the Equivalence Thesis
Maldonado, F., Rafael, F. J., Shinall, M. C., & Ely, E. W. (2020) · Critical Care Medicine · doi:10.1097/ccm.0000000000004475 · Cited by 112
Cost‐Effectiveness Analysis of the Most Common Orthopaedic Surgery Procedures: Knee Arthroscopy and Knee Anterior Cruciate Ligament Reconstruction
Lubowitz, J. H., & Appleby, D. (2011) · Arthroscopy The Journal of Arthroscopic and Related Surgery · doi:10.1016/j.arthro.2011.06.001 · Cited by 110
Combining multicriteria decision analysis, ethics and health technology assessment: applying the EVIDEM decisionmaking framework to growth hormone for Turner syndrome patients
Goetghebeur, M. M., Wagner, M., Khoury, H., Rindress, D., Grégoire, J., & Deal, C. (2010) · Cost Effectiveness and Resource Allocation · doi:10.1186/1478-7547-8-4 · Cited by 105
Literature Review and Global Consensus on Management of Acute Radiation Syndrome Affecting Nonhematopoietic Organ Systems
Dainiak, N., Gent, R. N., Carr, Z. A., Schneider, R., Bader, J. L., Buglova, E. E., Chao, N. J. A., Coleman, C. N., Ganser, A., Gorin, N. C., et al. (2011) · Disaster Medicine and Public Health Preparedness · doi:10.1001/dmp.2011.73 · Cited by 103
The Ethics of Creating a Resource Allocation Strategy During the COVID-19 Pandemic
Laventhal, N. T., Basak, R. B., Dell, M. L., Diekema, D. S., Elster, N. R., Geis, G. M., Mercurio, M. R., Opel, D. J., Shalowitz, D. I., Statter, M. B., et al. (2020) · PEDIATRICS · doi:10.1542/peds.2020-1243 · Cited by 101
Multivalue ethical framework for fair global allocation of a COVID-19 vaccine
Liu, Y., Salwi, S. R., & Drolet, B. C. (2020) · Journal of Medical Ethics · doi:10.1136/medethics-2020-106516 · Cited by 106
Within-country age-based prioritisation, global allocation, and public health impact of a vaccine against SARS-CoV-2: A mathematical modelling analysis
(2021) · doi:10.1016/j.vaccine.2021.04.002 · Cited by 101
Marketing HPV Vaccine
Rothman, S. M., & Rothman, D. J. (2009) · JAMA · doi:10.1001/jama.2009.1179 · Cited by 100
Measuring and monitoring equity in access to deceased donor kidney transplantation
Stewart, D. E., Wilk, A. R., Toll, A. E., Harper, A. M., Lehman, R., Robinson, A. M., Noreen, S. M., Edwards, E., & Klassen, D. K. (2018) · American Journal of Transplantation · doi:10.1111/ajt.14922 · Cited by 96
The burden of common chronic disease on health-related quality of life in an elderly community-dwelling population in the UK
Parker, L., Moran, G. M., Roberts, L. M., Calvert, M., & McCahon, D. (2014) · Family Practice · doi:10.1093/fampra/cmu035 · Cited by 91
A Costly Separation Between Withdrawing and Withholding Treatment in Intensive Care
Wilkinson, D. J. C., & Savulescu, J. (2012) · Bioethics · doi:10.1111/j.1467-8519.2012.01981.x · Cited by 95
Disability Discrimination, Medical Rationing and COVID-19
Chen, B. W., & McNamara, D. M. (2020) · Asian Bioethics Review · doi:10.1007/s41649-020-00147-x · Cited by 94
Community preferences for the allocation of solid organs for transplantation: a systematic review
Tong, A., Howard, K., Jan, S., Cass, A., Rose, J., Chadban, S., Allen, R. D., & Craig, J. C. (2010) · Transplantation · doi:10.1097/tp.0b013e3181cf1ee1 · Cited by 92
Waiting time predicts survival after liver transplantation for hepatocellular carcinoma: A cohort study using the United Network for Organ Sharing registry
Schlansky, B. L., Chen, Y., Scott, D. L., Austin, D. F., & Naugler, W. E. (2014) · Liver Transplantation · doi:10.1002/lt.23917 · Cited by 91
Uterus transplantation: ethical and regulatory challenges
Arora, K. S., & Blake, V. (2013) · Journal of Medical Ethics · doi:10.1136/medethics-2013-101400 · Cited by 89
The Ethical Advantages of Hard Determinism
Smilansky, S. (1994) · Oxford University Press eBooks · doi:10.1093/9780198993889.003.0027 · Cited by 92
Severity as a Priority Setting Criterion: Setting a Challenging Research Agenda
Barra, M., Broqvist, M., Gustavsson, E., Henriksson, M., Juth, N., Sandman, L., & Solberg, C. T. (2019) · Health Care Analysis · doi:10.1007/s10728-019-00371-z · Cited by 89
Conceptions of Care: Altruism, Feminism, and Mature Care
Pettersen, T. (2011) · Hypatia · doi:10.1111/j.1527-2001.2011.01197.x · Cited by 87
How to Fairly Allocate Scarce Medical Resources: Ethical Argumentation under Scrutiny by Health Professionals and Lay People
Krütli, P., Rosemann, T. J., Törnblom, K., & Smieszek, T. (2016) · PLoS ONE · doi:10.1371/journal.pone.0159086 · Cited by 87
COVID-19 Among African Americans: An Action Plan for Mitigating Disparities
Peek, M. E., Simons, R. A., Parker, W. F., Ansell, D. A., Rogers, S. O., & Edmonds, B. T. (2020) · American Journal of Public Health · doi:10.2105/ajph.2020.305990 · Cited by 85
Scarce-Resource Allocation and Patient Triage During the COVID-19 Pandemic
Kirkpatrick, J. N., Hull, S. C., Fedson, S., Mullen, B., & Goodlin, S. J. (2020) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2020.05.006 · Cited by 83
Ethical issues in pediatric emergency mass critical care
Antommaria, A. H. M., Powell, T. P., Miller, J. E., & Christian, M. D. (2011) · Pediatric Critical Care Medicine · doi:10.1097/pcc.0b013e318234a88b · Cited by 78
Telemedicine and Virtual Reality at Time of COVID-19 Pandemic: An Overview for Future Perspectives in Neurorehabilitation
Matamala-Gomez, M., Bottiroli, S., Realdon, O., Riva, G., Galvagni, L., Platz, T., Sandrini, G., Icco, R. D., & Tassorelli, C. (2021) · Frontiers in Neurology · doi:10.3389/fneur.2021.646902 · Cited by 82
Ethical implications of AI-driven clinical decision support systems on healthcare resource allocation: a qualitative study of healthcare professionals’ perspectives
Elgin, C. Y., & Elgin, C. (2024) · BMC Medical Ethics · doi:10.1186/s12910-024-01151-8 · Cited by 104
Evaluating Novel Therapies During the Ebola Epidemic
Joffe, S. (2014) · JAMA · doi:10.1001/jama.2014.12867 · Cited by 76
Uterus Transplantation: The Ethics of Using Deceased Versus Living Donors
Bruno, B., & Arora, K. S. (2018) · The American Journal of Bioethics · doi:10.1080/15265161.2018.1478018 · Cited by 76
Ethics in the Time of Coronavirus: Recommendations in the COVID-19 Pandemic
Kramer, J. B., Brown, D., & Kopar, P. K. (2020) · Journal of the American College of Surgeons · doi:10.1016/j.jamcollsurg.2020.04.004 · Cited by 74
Lifetime QALY prioritarianism in priority setting
Ottersen, T. (2012) · Journal of Medical Ethics · doi:10.1136/medethics-2012-100740 · Cited by 73
How do We Know When We are Treated Fairly? Justice Rules and Fairness Judgments
Cropanzano, R., Fortin, M., & Kirk, J. F. (2015) · Emerald Group Publishing Limited eBooks · doi:10.1108/s0742-730120150000033010 · Cited by 83
Beyond explainability: justifiability and contestability of algorithmic decision systems
Henin, C., & Le Métayer, D. (2022) · AI & SOCIETY · doi:10.1007/s00146-021-01251-8 · Cited by 71
Ethical Challenges in the Provision of Dialysis in Resource-Constrained Environments
Luyckx, V. A., Miljeteig, I., Ejigu, A. M., & Moosa, M. R. (2017) · Seminars in Nephrology · doi:10.1016/j.semnephrol.2017.02.007 · Cited by 70
Racial disparities in preemptive waitlisting and deceased donor kidney transplantation: Ethics and solutions
Reese, P. P., Mohan, S., King, K. L., Williams, W. W., Potluri, V. S., Harhay, M. N., & Eneanya, N. D. (2020) · American Journal of Transplantation · doi:10.1111/ajt.16392 · Cited by 70
Time to move to presumed consent for organ donation
Bird, S. M., & Harris, J. (2010) · BMJ · doi:10.1136/bmj.c2188 · Cited by 68
Ethics of ICU triage during COVID-19
Vinay, R., Baumann, H., & Biller‐Andorno, N. (2021) · British Medical Bulletin · doi:10.1093/bmb/ldab009 · Cited by 67
Donor-recipient matching: Myths and realities
Briceño, J., Ciria, R., & de la Mata, M. (2012) · Journal of Hepatology · doi:10.1016/j.jhep.2012.10.020 · Cited by 67
Are Older Adults Perceived as A Threat to Society? Exploring Perceived Age-Based Threats in 29 Nations
Ayalon, L. (2017) · The Journals of Gerontology Series B · doi:10.1093/geronb/gbx107 · Cited by 65
Which factors should be included in triage? An online survey of the attitudes of the UK general public to pandemic triage dilemmas
Wilkinson, D. J. C., Zohny, H., Kappes, A., Sinnott-Armstrong, W. P., & Savulescu, J. (2020) · BMJ Open · doi:10.1136/bmjopen-2020-045593 · Cited by 68
Simultaneous Thoracic and Abdominal Transplantation: Can We Justify Two Organs for One Recipient?
Wolf, J. H., Sulewski, M. E., Cassuto, J. R., Levine, M. H., Naji, A., Olthoff, K. M., Shaked, A. A., & Abt, P. L. (2013) · American Journal of Transplantation · doi:10.1111/ajt.12291 · Cited by 65
High-Efficiency Same-Day Approach to Breast Reconstruction During the COVID-19 Crisis
Specht, M. C., Sobti, N., Rosado, N., Tomczyk, E., Abbate, O. A., Ellis, D. B., & Liao, E. C.-W. (2020) · Breast Cancer Research and Treatment · doi:10.1007/s10549-020-05739-7 · Cited by 64
The shared ethical framework to allocate scarce medical resources: a lesson from COVID-19
Emanuel, E., & Persad, G. (2023) · The Lancet · doi:10.1016/s0140-6736(23)00812-7 · Cited by 66
Self-citation
Preferences for scarce medical resource allocation: Differences between experts and the general public and implications for the COVID‐19 pandemic
Grover, S., McClelland, A., & Furnham, A. F. (2020) · British Journal of Health Psychology · doi:10.1111/bjhp.12439 · Cited by 60
Use of the ‘Accountability for Reasonableness’ Approach to Improve Fairness in Accessing Dialysis in a Middle-Income Country
Moosa, M. R., Maree, J. D., Chirehwa, M., & Benatar, S. R. (2016) · PLoS ONE · doi:10.1371/journal.pone.0164201 · Cited by 61
Should Lack of Social Support Prevent Access to Organ Transplantation?
Berry, K. N., Daniels, N., & Ladin, K. (2019) · The American Journal of Bioethics · doi:10.1080/15265161.2019.1665728 · Cited by 62
Ethical Challenges with Multiple Myeloma BCMA Chimeric Antigen Receptor T Cell Slot Allocation: A Multi-Institution Experience
Kourelis, T., Bansal, R., Berdeja, J. G., Siegel, D. S. D., Patel, K. K., Mailankody, S., Htut, M., Shah, N. D., Wong, S. W. K., Sidana, S., et al. (2023) · Transplantation and Cellular Therapy · doi:10.1016/j.jtct.2023.01.012 · Cited by 57
Organ Shortage: The Greatest Challenge Facing Transplant Medicine
Shafran, D., Kodish, E. D., & Tzakis, A. G. (2014) · World Journal of Surgery · doi:10.1007/s00268-014-2639-3 · Cited by 57
Allocating Medical Resources in the Time of Covid-19
Liddell, K., Martin, S., & Palmer, S. (2020) · New England Journal of Medicine · doi:10.1056/nejmc2009666 · Cited by 57
Chemotherapy Drug Shortages in Pediatric Oncology: A Consensus Statement
DeCamp, M. W., Joffe, S., Fernandez, C. V., Faden, R., & Unguru, Y. (2014) · PEDIATRICS · doi:10.1542/peds.2013-2946 · Cited by 55
Six Signs of Scientism
Haack, S., & Romanian Academy - Iasi Branch (2012) · Logos & Episteme · doi:10.5840/logos-episteme20123151 · Cited by 59
Frailty Triage: Is Rationing Intensive Medical Treatment on the Grounds of Frailty Ethical?
Wilkinson, D. J. C. (2020) · The American Journal of Bioethics · doi:10.1080/15265161.2020.1851809 · Cited by 54
Prioritising access to pandemic influenza vaccine: a review of the ethics literature
Williams, J. H., & Dawson, A. (2020) · BMC Medical Ethics · doi:10.1186/s12910-020-00477-3 · Cited by 53
A modelling study investigating short and medium-term challenges for COVID-19 vaccination: From prioritisation to the relaxation of measures
Kiem, C. T., Massonnaud, C., Lévy-Bruhl, D., Poletto, C., Colizza, V., Bosetti, P., Fontanet, A. L., Gabet, A., Olié, V., Zanetti, L. C. D. S., et al. (2021) · EClinicalMedicine · doi:10.1016/j.eclinm.2021.101001 · Cited by 57
Cost Consideration in the Clinical Guidance Documents of Physician Specialty Societies in the United States
Schwartz, J. A. T., & Pearson, S. D. (2013) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2013.817 · Cited by 53
Coping With Critical Drug Shortages
Rosoff, P. M., Patel, K. R., Scates, A., Rhea, G., Bush, P. W., & Govert, J. A. (2012) · Archives of Internal Medicine · doi:10.1001/archinternmed.2012.4367 · Cited by 55
When clinical trials compete: prioritising study recruitment
Gelinas, L. C., Lynch, H. F., Bierer, B. E., & Cohen, I. G. (2017) · Journal of Medical Ethics · doi:10.1136/medethics-2016-103680 · Cited by 52
Management of prostate cancer patients during COVID-19 pandemic
Öbek, C., Doğanca, T., Argun, Ö. B., & Kural, A. R. (2020) · Prostate Cancer and Prostatic Diseases · doi:10.1038/s41391-020-0258-7 · Cited by 51
Public attitudes toward allocating scarce resources in the COVID-19 pandemic
Buckwalter, W., & Peterson, A. H. (2020) · PLoS ONE · doi:10.1371/journal.pone.0240651 · Cited by 50
Principles of Scarce Medical Resource Allocation in Natural Disaster Relief
Cao, H. Y., & Huang, S.-M. (2012) · Medical Decision Making · doi:10.1177/0272989x12437247 · Cited by 49
Justice Under Uncertainty
Cettolin, E., & Riedl, A. M. (2016) · Management Science · doi:10.1287/mnsc.2016.2535 · Cited by 47
Corruption and COVID-19
Rose‐Ackerman, S. (2021) · EUNOMÍA Revista en Cultura de la Legalidad · doi:10.20318/eunomia.2021.6061 · Cited by 48
Global Patterns of QALY and DALY Use in Surgical Cost-Utility Analyses: A Systematic Review
Rios-Diaz, A. J., Lam, J., Ramos, M. S., Moscoso, A. V., Vaughn, P., Zogg, C. K., & Caterson, E. J. (2016) · PLoS ONE · doi:10.1371/journal.pone.0148304 · Cited by 47
Market and non-market mechanisms for the optimal allocation of scarce resources
Condorelli, D. (2013) · Games and Economic Behavior · doi:10.1016/j.geb.2013.08.008 · Cited by 47
The Societal Impact of Single Versus Bilateral Lung Transplantation for Chronic Obstructive Pulmonary Disease
Munson, J. C., Christie, J. D., & Halpern, S. D. (2011) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201104-0695oc · Cited by 47
Ethical Considerations Surrounding Survival Benefit–Based Liver Allocation
Keller, E. J., Kwo, P. Y., & Helft, P. R. (2013) · Liver Transplantation · doi:10.1002/lt.23780 · Cited by 46
Complete Lives in the Balance
Kerstein, S. J., & Bognar, G. (2010) · The American Journal of Bioethics · doi:10.1080/15265160903581718 · Cited by 46
Priority Setting as an Ethical Imperative in Managing Global Dialysis Access and Improving Kidney Care
Luyckx, V. A., & Moosa, M. R. (2021) · Seminars in Nephrology · doi:10.1016/j.semnephrol.2021.05.004 · Cited by 45
Which health technologies should be funded? A prioritization framework based explicitly on value for money
Golan, O. G., & Hansen, P. (2012) · Israel Journal of Health Policy Research · doi:10.1186/2045-4015-1-44 · Cited by 45
Triage and justice in an unjust pandemic: ethical allocation of scarce medical resources in the setting of racial and socioeconomic disparities
Tolchin, B. D., Hull, S. C., & Kraschel, K. (2020) · Journal of Medical Ethics · doi:10.1136/medethics-2020-106457 · Cited by 45
Taking Equality Seriously: Applying Human Rights Frameworks to Priority Setting in Health
Yamin, A. E., & Norheim, O. F. (2014) · Human Rights Quarterly · doi:10.1353/hrq.2014.0027 · Cited by 46
Systematic Review of Public Preferences for the Allocation of Donor Organs for Transplantation: Principles of Distributive Justice
Oedingen, C., Bartling, T., Mühlbacher, A. C., Schrem, H., & Krauth, C. (2019) · Patient · doi:10.1007/s40271-019-00363-0 · Cited by 44
COVID-19 and Moral Distress: A Pediatric Critical Care Survey
Thomas, T., Davis, F. D., Kumar, S., Thammasitboon, S., & Rushton, C. H. (2021) · American Journal of Critical Care · doi:10.4037/ajcc2021999 · Cited by 44
Equal Opportunity Supplemented by Fair Innings: Equity and Efficiency in Allocating Deceased Donor Kidneys
Ross, L. F., Parker, W. F., Veatch, R. M., Gentry, S. E., & Thistlethwaite, J. R. (2012) · American Journal of Transplantation · doi:10.1111/j.1600-6143.2012.04141.x · Cited by 44
A Hostage Situation
Smilansky, S. (2019) · Oxford University Press eBooks · doi:10.1093/9780198993889.003.0003 · Cited by 47
Justice in COVID-19 vaccine prioritisation: rethinking the approach
Rhodes, R. (2021) · Journal of Medical Ethics · doi:10.1136/medethics-2020-107117 · Cited by 43
Liver transplantation for hepatocellular carcinoma through the lens of transplant benefit
Cillo, U., Vitale, A., Polacco, M., & Fasolo, E. (2016) · Hepatology · doi:10.1002/hep.28998 · Cited by 43
Ethics in the time of COVID
Kim, S. Y. H., & Grady, C. (2020) · Neurology · doi:10.1212/wnl.0000000000009520 · Cited by 43
Safe Reintroduction of Cardiovascular Services During the COVID-19 Pandemic
Wood, D. A., Mahmud, E., Thourani, V. H., Sathananthan, J., Virani, A., Poppas, A., Harrington, R. A., Dearani, J. A., Swaminathan, M., Russo, A. M., et al. (2020) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2020.04.063 · Cited by 42

Authors: Persad, G., Wertheimer, A., & Emanuel, E. J.
Affiliations: National Institutes of Health (US)
Corresponding author: Emanuel, Ezekiel J
ORCID: Persad, Govind
Emanuel, Ezekiel J
Venue: The Lancet
Publisher: Elsevier BV
Published: 2009-01
Volume: 373
Issue: 9661
Pages: 423-431
ISSN: 0099-5355 (ISSN-L)
0140-6736
DOI: 10.1016/s0140-6736(09)60137-9
OpenAlex: W2133393736
Cited by: 929
References: 91
Citations by year: 2026: 72 · 2025: 46 · 2024: 52 · 2023: 56 · 2022: 82 · 2021: 115 · 2020: 119 · 2019: 35 · 2018: 29 · 2017: 39 · 2016: 44 · 2015: 31 · 2014: 36 · 2013: 29 · 2012: 53
FWCI: 47.73
Type: journal article
Language: en
Open access: green
philarchive.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: The Lancet (publishedVersion)
PubMed (publishedVersion)
PhilPapers (PhilPapers Foundation) (submittedVersion)
Colorado Law Scholarly Commons (University of Colorado Colorado Springs) (submittedVersion)
eYLS (Yale Law School) (submittedVersion)
DigitalGeorgetown (Georgetown University Library) (submittedVersion)
Funders: U.S. Department of Health and Human Services
National Institutes of Health
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Organ Donation and Transplantation
Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
Keywords: allocation of scarce medical resources, organ allocation, vaccine allocation, allocation principles, equal treatment, social utility, quality-adjusted life years, disability-adjusted life years, lottery allocation, prognosis, instrumental values, resource allocation ethics
MeSH terms: Age Factors, Ethics, Medical, Health Priorities, Humans, Morals, Prognosis, Health Care Rationing, Patient Selection, Quality-Adjusted Life Years, Resource Allocation

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Principles for allocation of scarce medical interventions

Abstract

Overview

Integrity signals

Verification

Claims the paper makes

Claims other papers make about this one

Self-check

Citations

Cites

Cited by

Related

Metadata

Record

About these checks