Footnotes

• Competing interests None.

• Provenance and peer review Commissioned; externally peer reviewed.

• ↵i The notion of ‘fairness’ that is at work in the context of ‘fair rationing’ is usually understood more narrowly than it is in other contexts. Questions of fairness, more broadly conceived, will also arise in connection with the size of the budget allocated to healthcare: for example, concerns of fairness are likely to be relevant when deciding how much to allocate to healthcare relative to, for instance, education. I leave these issues aside for the purposes of the present discussion.

• ↵ii There may be instances where clinicians can redress the resource shortages their previous, inefficient decisions have created, for example by working unpaid overtime or providing private funds. In such cases, clinicians arguably have a duty to provide such redress (although of course whether or not we would want to enforce such a duty as a matter of policy is a separate question). I thank an anonymous reviewer for raising this point.