ABSTRACT
Explicit rationing of medical care—that is, the deliberate denial of treatment for some individuals who might benefit from it—may seem totally alien to our expectations about access to health care. Rising health care costs and constraints on spending have forced to consider rationing some health care because it costs too much. The rationing criteria established for heart transplants will set an important precedent for future decisions about access to advanced medical techniques. A utilitarian rationing scheme would explicitly employ the kinds of social worth criteria that are an implicit element in many medical criteria. Medical condition is easily evaluated on an individual basis. A good argument can be made that anyone who can benefit from a heart transplant under purely medical criteria is otherwise qualified. Government regulations specifically prohibit a health care facility from discriminating in admission or treatment against a drug or alcohol abuser who seeks treatment for a medical condition.
