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Justice and the NICE approach
  1. Richard Cookson
  1. Correspondence to Dr Richard Cookson, Centre for Health Economics, University of York, York YO10 5DD, UK; richard.cookson{at}


When thinking about population level healthcare priority setting decisions, such as those made by the National Institute for Health and Care Excellence, good medical ethics requires attention to three main principles of health justice: (1) cost-effectiveness, an aspect of beneficence, (2) non-discrimination, and (3) priority to the worse off in terms of both current severity of illness and lifetime health. Applying these principles requires consideration of the identified patients who benefit from decisions and the unidentified patients who bear the opportunity costs.

  • Allocation of Health Care Resources
  • Ethics
  • Distributive Justice
  • Health Care Economics

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