ABSTRACT
Explicit forms of rationing have been implemented in many countries. Most of these prioritization systems use Daniels’ accountability for reasonableness methodology. However, a question remains about whether accountability for reasonableness is both legitimate and fair. This chapter aims to try to adjust accountability for reasonableness to the World Health Organization’s (WHO’s) holistic view of health and to propose an evolutionary perspective in relation to the normal functioning standard proposed by Daniels.
To accomplish this purpose, this chapter departs from the normal functioning standard to a model that promotes effective opportunity for everyone in healthcare access. This is because even within the normal functioning criteria, some treatments should have priority over others. The equal opportunity function ((EO)F) is a mathematical function that helps to hierarchize morally relevant necessities in healthcare according to this perspective. Accountability for reasonableness is a valuable tool to address the issue of setting limits in healthcare. The (EO)F may reflect how accountability for reasonableness results in fair limit-setting decisions. When resources are especially scarce, the suggested methodology may not only allow for prioritizing on an all-or-nothing basis but also contribute to a hierarchy system of priorities in healthcare.
