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J Med Ethics 31:476-480 doi:10.1136/jme.2004.010421
  • Medical ethics

Responsibility in health care: a liberal egalitarian approach

  1. A W Cappelen1,
  2. O F Norheim2
  1. 1Department of Economics, University of Oslo and the Norwegian School of Economics, Norway
  2. 2Division for Medical Ethics and the Philosophy of Science, Department of Public Health and Primary Care, University of Bergen, Norway
  1. Correspondence to:
 Ole Frithjof Norheim
 Professor, Division for Medical Ethics and the Philosophy of Science, Department of Public Health and Primary Care, University of Bergen, Kalfarveien 31, N-5018 Bergen, Norway; ole.norheimisf.uib.no
  • Received 25 August 2004
  • Accepted 14 October 2004

Abstract

Lifestyle diseases constitute an increasing proportion of health problems and this trend is likely to continue. A better understanding of the responsibility argument is important for the assessment of policies aimed at meeting this challenge. Holding individuals accountable for their choices in the context of health care is, however, controversial. There are powerful arguments both for and against such policies. In this article the main arguments for and the traditional arguments against the use of individual responsibility as a criterion for the distribution of scarce health resources will be briefly outlined. It is argued that one of the most prominent contemporary normative traditions, liberal egalitarianism, presents a way of holding individuals accountable for their choices that avoids most of the problems pointed out by the critics. The aim of the article is to propose a plausible interpretation of liberal egalitarianism with respect to responsibility and health care and assess it against reasonable counter-arguments.

Footnotes

  • Competing interests: none declared