ABSTRACT
All modern healthcare systems face the problem of rising healthcare costs. Personal responsibility, if used as a reason for making decisions about the healthcare resources patients receive, is often perceived as 'blaming the victim' and as contrary to intuitions of justice and compassion in medicine. A 'pure' liberal egalitarian system always faces the problem of becoming a 'bottomless pit'. In order to set limits to healthcare provision and to ration fairly, the principle of solidarity, and with it the notion of personal responsibility, could be used as an allocation criterion. In liberal healthcare systems based to some degree on solidarity, personal responsibility can be legitimately demanded. Personal responsibility requires knowledge, and the health literacy of large parts of the population remains insufficient. Personal responsibility on a theoretical level has been defended and a way to avoid some of the practical problems connected to implementation proposed.
