Best interests and sufficient benefit: The ethics of hard decisions in healthcare

Healthcare decisions often focus on patients' "best interests". This has limits. Many think we should distribute health resources in ways that promote population health, but also respect individual claims. Yet resource constraints mean we cannot promote everyone's best interests. The idea of best interests is also of limited help in cases where people disagree on what is best for critically ill infants, e.g. seeking novel treatments or providing palliative care. My project explores whether the idea of "sufficiency" can help with these challenging decisions by offering a principle of justice that is less demanding than best interests. Sufficiency-based approaches emphasise the moral importance of keeping people above particular thresholds (e.g., the level of autonomy that allows people to make important decisions about their lives). I will build on recent work in political philosophy, developing a novel principle of sufficiency theory that is responsive to the practical needs of healthcare decision-making.