Setting Priorities versus Managing Closures: What is the Ethically Most Sound Way of Handling Changes in the Health Care System?

Abstract

The answer to the question of the title depends on a number of circumstances, and I go through and comment on five of them. Then an attempt is made to keep some of these circumstances constant and vary others in order to highlight the importance of their ethical points of departure. The pros and cons of various choices are discussed and conclusions are suggested. To make further progress, the original question in the title is replaced by two new questions: under what conditions is managing closures the ethically soundest way of handling changes in the health-care system? And, under what conditions is setting priorities the ethically soundest way of handling changes in the health care system? Some tentative answers to these questions are outlined towards the end of this paper.