A Utilitarian Approach to Justice in Health Care

This chapter examines a utilitarian approach to distributive justice in health care, according to which the goal of a just health care system ought to be the “greatest good for the greatest number.” It considers the adequacy of alternative theories of distributive justice for resolving issues about health care allocation, focusing on egalitarianism, in its several variations, as the main alternative to utilitarianism. It argues that applying egalitarian principles to problems about allocating health care yields implausible results. It also presents a nuanced utilitarianism meant to support values of equality, clear up some confusion about the issue of aggregation, and comply with intuitions about deontological constraints about sacrificing less healthy individuals for those with better prospects for recovery. The chapter looks at a hypothetical example in which a utilitarian transplant surgeon kills an innocent person and harvests the victim’s organs to save the lives of five other people.