Rapid developments in medicine and medical technology during recent years have created a variety of ethical dilemmas including the allocation of limited or scarce resources such as money, instruments, medications, health-care facilities, time and manpower. This is quite a new dilemma, which has been created due to the advancements in very expensive scientific and technological measures. No coun...

Allocation of very scarce medical interventions such as organs and vaccines is a persistent ethical challenge. We evaluate eight simple allocation principles that can be classified into four categories: treating people equally, favouring the worst-off, maximising total benefits, and promoting and rewarding social usefulness. No single principle is sufficient to incorporate all morally relevant ...

The authors report and comment on student reactions to a clinical example of moral choice in the microallocation of scarce resources. Four patients require dialysis simultaneously, but only one kidney machine is available. What moral, as opposed to clinical, criteria are available to determine who should have priority?

The 1998 settlement of a lawsuit by the state of California required 19 pharmaceutical firms to provide $150 million worth of drugs free of charge to more than 150 California clinics and hospitals over a three-year period. We developed a decision-support system that utilizes a multiobjective optimization model and a heuristic solution taking into account the efficiency, effectiveness, and equit...

The number of critical medication shortages in the United States has reached an unprecedented level, requiring decisions about allocating limited drug supplies. Ad hoc decisions are susceptible to arbitrary judgments, revealing preformed biases for or against groups of people. Health care institutions lack standardized protocols for rationing scarce drugs. We describe the principles on which an...

AI is increasingly used to aid decision-making about the allocation of scarce societal resources, for example housing homeless people, organs transplantation, and food donations. Recently, there have been several proposals how design objectives these systems that attempt achieve some combination fairness, efficiency, incentive compatibility, satisfactory aggregation stakeholder preferences. Thi...