Four Unsolved Rationing Problems A Challenge

In his presentation to the inaugural congress of the International of Bioethics, Norman Daniels discussed four key problems that face trying to provide medical care in a climate of scarce resources: to what we should favor best outcomes in allocating resources; what priority we to give to the neediest; when providing modest benefits to many should privileged over providing significant benefits to fewer people; and when we to rely on democratic processes to determine what is a fair outcome of. He argued that bioethics generally -- and current theories of particularly -- has failed to address these problems directly. In this, we have invited Professor Daniels to issue his fourfold challenge and invited responses from four distinguished scholars in philosophy, , economics, and public policy. The following essays by Frances Kamm, Eric, John Broome, and Mary Ann Baily begin the hard work of solving these problems and so, in Daniels's words, begin to bridge the gap between of distributive justice and the creation of just institutions.