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Commentary
Sustainable healthcare resource allocation, grounding theories and operational principles: response to our commentators
  1. Christian Munthe1,2,
  2. Davide Fumagalli1,2,
  3. Erik Malmqvist1,2
  1. 1 Centre for Antibiotic Resistance Research (CARe), Goteborgs Universitet, Goteborg, Sweden
  2. 2 Department of Philosophy, Linguistics and Theory of Science, Goteborgs Universitet, Goteborg, Sweden
  1. Correspondence to Professor Christian Munthe, Philosophy, Linguistics and Theory of Science, Goteborgs Universitet, Goteborg SE-40530, Sweden; christian.munthe{at}gu.se

https://doi.org/10.1136/medethics-2021-107299

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    We proposed adding a sustainability principle to the operational ethical principles guiding public healthcare resources allocation decisions.1 All our commentators2–6 acknowledge our core message: healthcare needs to pay (much better) attention to the future. They also strengthen our proposal by offering support by luck egalitarian2 and Rawlsian3 arguments, and helpfully point out ambiguities and gaps requiring attention in the further development of the proposal, and its practical implementation.

    We here consider some more substantial objections.

    Vong6 claims that healthcare resource allocation decisions already take dynamic effects into account. We agree that they sometimes do, and illustrated this in our article, but also demonstrated that they do so arbitrarily, systematically ignoring important negative dynamics.

    Several commentaries highlight the importance of distinguishing philosophical theories which justify …

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    Footnotes

    • Twitter @christianmunthe, @erik_malmqvist

    • Contributors CM led the drafting of the response and collaborated with both DF and EM in its finalisation. DF contributed to the finalisation of the response. EM contributed initial analysis and contributed to the finalisation of the response. All three authors authorised the final version before submission.

    • Funding This research was supported by the UGOT Challenges Initiative at the University of Gothenburg; the Swedish Research Council (VR), contract number 2018-05771, for the project EDAR: The Environment as a Driver for Antibiotic Resistance; and the Swedish Innovation Agency VINNOVA, contract number 2018-00433, for the project PLATINEA: Platform for Innovation of Existing Antibiotics.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.

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