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Rationing: the loss of a concept
  1. Hugh Upton
  1. Correspondence to Dr Hugh Upton, College of Human & Health Sciences, Swansea University, Swansea SA2 8PP, UK; h.r.upton{at}


In the literature on the subject there is a trend towards understanding the idea of rationing in healthcare very broadly, to include any form of restriction in supply. It is suggested in this paper that there are good reasons to resist this move, since it would both render the concept redundant through being trivially true and displace an earlier, egalitarian one that retains great moral significance for the supply of healthcare. The nature and significance of the narrower, egalitarian conception is set out, drawing particular attention to the fact that it marks a contrast with the idea of prioritising certain people or groups over others and to the fact that it is a form of rationing that is plausibly regarded as a morally desirable response to severe shortages. It is contrasted with the broad conception and arguments in favour of this latter are considered and rejected.

  • Allocation of healthcare resources

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  • Competing interests None.

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

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