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The Rule of Rescue

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  • McKie, John
  • Richardson, Jeff

Abstract

Jonsen coined the term "Rule of Rescue"(RR) to describe the imperative people feel to rescue identifiable individuals facing avoidable death. In this paper we attempt to draw a more detailed picture of the RR, identifying its conflict with cost-effectiveness analysis, the preference it entails for identifiable over statistical lives, the shock-horror response it elicits, the preference it entails for lifesaving over non-lifesaving measures, its extension to non-life-threatening conditions, and whether it is motivated by duty or sympathy. We also consider the measurement problems it raises, and argue that quantifying the RR would probably require a two-stage procedure. In the first stage the size of the individual utility gain from a health intervention would be assessed using a technique such as the Standard Gamble or the Time Trade-Off, and in the second the social benefits arising from the RR would be quantified employing the Person Trade-Off. We also consider the normative status of the RR. We argue that it can be defended from a utilitarian point of view, on the ground that rescues increase well-being by reinforcing people's belief that they live in a community that places great value upon life. However, utilitarianism has long been criticised for failing to take sufficient account of fairness, and the case is no different here: fairness requires that we do not discriminate between individuals on morally irrelevant grounds, whereas being "identifiable" does not seem to be a morally relevant ground for discrimination.

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Bibliographic Info

Article provided by Elsevier in its journal Social Science & Medicine.

Volume (Year): 56 (2003)
Issue (Month): 12 (June)
Pages: 2407-2419

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Handle: RePEc:eee:socmed:v:56:y:2003:i:12:p:2407-2419

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Related research

Keywords: Rule of Rescue Utilitarianism Fairness Cost-effectiveness analysis QALY;

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Cited by:
  1. Robin Pope & Reinhard Selten & Johannes Kaiser & Sebastian Kube & Jürgen Hagen, 2012. "Exchange rate determination: a theory of the decisive role of central bank cooperation and conflict," International Economics and Economic Policy, Springer, vol. 9(1), pages 13-51, March.
  2. Richardson, Jeff & Sinha, Kompal & Iezzi, Angelo & Maxwell, Aimee, 2012. "Maximising health versus sharing: Measuring preferences for the allocation of the health budget," Social Science & Medicine, Elsevier, vol. 75(8), pages 1351-1361.
  3. José-Luis Pinto-Prades & José-María Abellán-Perpiñán, 2004. "Mesuring the Health of Populations: The Veil of Ignorance Approach," Working Papers 116, Barcelona Graduate School of Economics.
  4. E. Wetering & E. Stolk & N. Exel & W. Brouwer, 2013. "Balancing equity and efficiency in the Dutch basic benefits package using the principle of proportional shortfall," The European Journal of Health Economics, Springer, vol. 14(1), pages 107-115, February.
  5. James K. Hammitt & Nicolas Treich, 2007. "Statistical vs. Identified Lives in Benefit-Cost Analysis," CESifo Working Paper Series 1931, CESifo Group Munich.
  6. Erik Nord & Jose Luis Pinto & Jeff Richardson & Paul Menzel & Peter Ubel, 1999. "Incorporating societal concerns for fairness in numerical valuations of health programmes," Health Economics, John Wiley & Sons, Ltd., vol. 8(1), pages 25-39.
  7. David Canning, 2006. "The Economics of HIV/AIDS in Low-Income Countries: The Case for Prevention," Journal of Economic Perspectives, American Economic Association, vol. 20(3), pages 121-142, Summer.
  8. Calain, Philippe, 2013. "Ethics and images of suffering bodies in humanitarian medicine," Social Science & Medicine, Elsevier, vol. 98(C), pages 278-285.
  9. Richardson, Jeff & McKie, John, 2007. "Economic evaluation of services for a National Health Scheme: The case for a fairness-based framework," Journal of Health Economics, Elsevier, vol. 26(4), pages 785-799, July.
  10. Angermeyer, Matthias C. & Matschinger, Herbert & Link, Bruce G. & Schomerus, Georg, 2014. "Public attitudes regarding individual and structural discrimination: Two sides of the same coin?," Social Science & Medicine, Elsevier, vol. 103(C), pages 60-66.
  11. Erik Nord & Paul Menzel & Jeff Richardson, 2003. "The value of life: individual preferences and social choice. A comment to Magnus Johannesson," Health Economics, John Wiley & Sons, Ltd., vol. 12(10), pages 873-877.
  12. Dolan, Paul & Tsuchiya, Aki, 2005. "Health priorities and public preferences: the relative importance of past health experience and future health prospects," Journal of Health Economics, Elsevier, vol. 24(4), pages 703-714, July.
  13. Ramon Abel Castaño, 2006. "Los mandatos constitucionales sobre el derecho a la salud: implicaciones de equidad y eficiencia," DOCUMENTOS DE TRABAJO 003173, UNIVERSIDAD DEL ROSARIO.

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