RT Journal Article SR Electronic T1 The significance of ‘severity’ JF Journal of Medical Ethics JO J Med Ethics FD BMJ Publishing Group Ltd and Institute of Medical Ethics SP 545 OP 551 DO 10.1136/medethics-2018-105058 VO 45 IS 8 A1 Hausman, Daniel YR 2019 UL http://jme.bmj.com/content/45/8/545.abstract AB 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.