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The significance of ‘severity’
  1. Daniel Hausman
  1. Philosophy, University of Wisconsin-Madison, Madison, Wisconsin, USA
  1. Correspondence to Dr Daniel Hausman, Philosophy, University of Wisconsin-Madison, Madison, Wisconsin 53711, USA; dhausman{at}


This essay considers whether permitting the cost-effectiveness of healthcare to govern its allocation is ethically objectionable on the grounds that it fails to give sufficient weight to the severity of people’s health states. After documenting the popular sentiment that appears to support this criticism, the essay considers how to implement prioritising severity, focusing on Erik Nord’s work. The remainder of the essay scrutinises the ethical arguments supporting policies prioritising severity and challenges those who would prioritise severity to define a notion of severity whose prioritisation they can defend.

  • health economics
  • philosophy of medicine
  • public policy
  • healthcare economics
  • public health ethics

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  • Contributors This essay is solely my own work.

  • Funding This research was done largely as a Ludwig Lachmann Fellow at the London School of Economics and Political Science, and I am grateful both for the funding and for the wonderful working environment in the Center for the Philosophy of the Natural and Social Sciences.

  • Competing interests None declared.

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

  • Patient consent for publication Not required.

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