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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
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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.

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Research works printed but not linked: 3

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

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Metadata

Authors
Persad, G., Wertheimer, A., & Emanuel, E. J.
Affiliations
National Institutes of Health (US)
Corresponding author
Emanuel, Ezekiel J
ORCID
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
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

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