Accountability for reasonableness and priority setting in health norman daniels 1 the problem of priority setting priority setting is required whenever a society must . Accountability for reasonableness (afr) is an ethical framework for priority setting that aims at ensuring that the process towards setting priorities is fair, and that the actually decided-upon priorities are based on reasons that are communicated to all relevant parties involved. Want to give more priority to the worst off, some less some will be willing to aggregate benefits in ways that others are not accountability for reasonableness .
Accounts of what constitutes fair and legitimate priority setting in healthcare include daniels’ and sabin's accountability for reasonableness (a4r) and clark's and . Table 2: four principles of “accountability for reasonableness” transparency public visibility of ethnical framework/principles/rationale behind priorities. Fairness is a key goal of priority setting and ‘accountability for reasonableness’ has emerged as the leading framework for fair priority setting.
Establishing a fair porcess for priority setting is easier than agreeing on principles accountability for reasonableness author(s) accountability and . Accountability for reasonableness was developed from research on allocation of healthcare resources and was initially formulated as a tool for priority setting and rationing but use of the framework has been extended to other areas of health policy. Accountability for reasonableness in priority setting: theory and applications norman daniels, harvard school of public health rotterdam, netherlands, december 9, 2010. Accountability for reasonableness a priority setting concept is it useful for community monitoring under severe resource constraints by jens byskov for the convening on community monitoring for accountability in health july 2011. Health policy 61 (2002) 279–290 fairness, accountability for reasonableness, and the views of priority setting decision-makers douglas k martin a,, mita giacomini b, peter a singer c.
Accounts of what constitutes fair and legitimate priority setting in healthcare include daniels’ and sabin's accountability for reasonableness (a4r) and clark's and weale's framework for the identification of social values. Accountability for reasonableness establishing a fair process for priority setting is easier than agreeing on principles the ethics of accountability in . The accountability for reasonableness framework underscores how giving reasons is a way to achieve acceptance and compliance from stakeholders who have diverse perspectives on the limit-setting . The priority-setting decision to use artemether-lumefantrine as the first-line antimalarial drug failed to satisfy the four conditions of the accountability for reasonableness framework in our understanding, this is the first study to evaluate priority-setting decisions for new drugs in tanzania against the accountability for reasonableness .
On the basis of those empirical observations and normative perspectives derived from philosophy and political science, we proposed a framework – “accountability for reasonableness” – as an account of fairness in setting priorities and limits and a broad how-to-do-it approach. Fairness, accountability for reasonableness, and the views of priority setting decision-makers. Priority setting for the implementation of artemisinin-based combination therapy policy in tanzania: evaluation against the accountability for reasonableness framework implementation science 2012.
The accountability for reasonableness approach to guide priority setting in health systems within limited resources – findings from action research at district level in kenya, tanzania, and zambia health research policy and systems , vol 12, issue 1,. This paper is a critique of norman daniels' and james sabin's accountability for reasonableness framework for making priority-setting decisions in health care i. Accountability for reasonableness in an institutional setting july 19, 2017 july 19, 2017 ethoxblog accountability for reasonableness , health care priority-setting , norwegian national council for priority setting in health care , procedural justice. Accountability for reasonableness (afr) is an ethics-based approach to a legitimate and fair priority-setting process that builds upon four conditions: relevance, publicity, appeals, and enforcement, which facilitate agreement on priority-setting decisions and gain support for their implementation.