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How the past matters for the future: a luck egalitarian sustainability principle for healthcare resource allocation
  1. Andreas Albertsen
  1. School of Business and Social Sciences: Department of Political Science, Aarhus University, Aarhus, Midtjylland, Denmark
  1. Correspondence to Andreas Albertsen, School of Business and Social Sciences: Department of Political Science, Aarhus University, 8000 Aarhus, Midtjylland, Denmark; aba{at}

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Christian Munthe, David Fumagalli and Erik Malmqvist argue that well-known healthcare resource allocation principles, such as need, prognosis, equal treatment and cost-effectiveness, should be supplemented with a principle of sustainability.1 Employing such a principle would entail that the allocation of healthcare resources should take into account whether a specific allocation causes negative dynamics, which would limit the amount of resources available in the future. As examples of allocation decisions, which may have such negative dynamics, they mention those who cause a lack of vaccines, anti-bioethics resistance and drug shortages. Thus, the overall thought is that we can spend and allocate healthcare resources in a certain way at t1, which means that we will have fewer resources available at a later point, t2. The authors argue that we should include a principle of sustainability to justify allocations, which avoids or diminishes the negative dynamics. The authors argue that existing principles cannot sufficiently include proper regard for how our current decisions affect future allocation decisions and, therefore, the people who need healthcare resources in the future.

I am sympathetic to the developed argument and believe that the authors are correct that negative dynamics provide reasons to take our ability to meet future health needs …

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  • Contributors Sole authored manuscript.

  • Funding This study was funded by Det Frie Forskningsråd (33501).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.

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