Futility,Autonomy,and Cost in End-of-Life Care

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A common analogy used to explain this is the situation that arises when people dining out together decide in advance to split the check. Each person has an incentive to order a more expensive meal, yet the group as a whole must pay the total cost. If the check is to be evenly divided, it would be wise to agree to choose from a limited menu, i.e., to submit to some (non-price) rationing.

Pope T. M. , “Involuntary Passive Euthanasia in US Courts: Reassessing the Judicial Treatment of Medical Futility Cases,” Marquette Elder's Advisor 9, no. 2 (2008): 229–268.

Jennings B. Ryndes T. D'Onofrio C. Baily M. A. , “Access to Hospice Care: Expanding Boundaries, Overcoming Barriers,” Hastings Center Report 33, no. 2, Special Supplement (2003): S3–S59.

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In Kenneth Arrow's seminal article on health economics he notes that often a social policy that seems to be based on a concern for distributional justice is actually a policy that compensates for the inability of private insurance markets, including health insurance markets, to be able to provide people with the security they want in a world of uncertainty. Arrow K. J. , “Uncertainty and the Welfare Economics of Medical Care,” American Economic Review 53, no. 5 (1963): 941–973, at 947.

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