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JuSTage - Towards a Just, Stage-of-Life Sensitive Allocation of Healthcare Resources

Funder: UK Research and InnovationProject code: AH/Z506072/1
Funded under: AHRC Funder Contribution: 796,698 GBP

JuSTage - Towards a Just, Stage-of-Life Sensitive Allocation of Healthcare Resources

Description

Decisions about distributing health resources between different people and medical needs are difficult and controversial. In this project we propose to investigate how healthcare resources should be distributed across the lifespan and across different age groups. This investigation, relatively unexamined within healthcare policy research and ethics, is particularly timely. Shifting demographics, resource constraints, and exacerbated by the pandemic inequalities, pose significant challenges for the NHS and highlight the pressing need to ensure fair treatment for all age groups in healthcare services. In healthcare decision-making, connections between age and resource allocation have predominantly focused on adhering to the apparent requirement that we do not discriminate based on age. This often leads to a simplistic approach that people of all ages should be treated the same in order to be treated fairly. Regrettably, despite best intentions, this approach cannot consistently achieve fairness. Instead, it gives rise to new forms of injustice by obscuring underlying realities and needs. Currently, distinctive needs across the lifespan and the unique ways in which individuals at various life stages are impacted by healthcare are not properly considered in decision-making processes. Important challenges are often overlooked. These, for instance, include transitional phases; the specific requirements on individuals dealing with conditions at atypical ages; and the complex interplay between vulnerabilities associated with different life-stages and socio-economic factors. These omissions contribute to and exacerbate existing inequalities. Many older individuals, lacking post-operative support, experience isolation and diminished well-being. Children with complex medical conditions, waiting on backlogged lists, often miss out on time-critical developmental treatments constraining their life opportunities. Women experiencing menopause and adolescents battling mental health challenges frequently encounter suboptimal care, exacerbating health and social issues that could otherwise be alleviated. Children within palliative care services, which are generally tailored and funded for older patients, may not receive the emotional and physical support they require. This project will illuminate these currently overlooked inequalities. By exploring the critical intersection between age and healthcare justice, this work will help determine how to allocate resources in order to avoid unfair discrimination against different population groups. The study will proceed, first, to identify and analyse age-related assumptions in healthcare resource allocation in order to understand their impact on healthcare access from early life to late adulthood. Second, it will explore the legal and ethical dimensions of healthcare inequalities among age groups in order to identify overlooked injustices. Finally, collaborating with commissioners, providers, patient and policy organisations, it will develop and test the applicability of a 'stage-of-life sensitive' approach for decision-making. This approach will be more responsive to healthcare needs across the lifespan and will be adaptable to different processes and regional policy contexts. Findings will raise awareness of overlooked healthcare injustices among decision-makers, academics, and the public, aiming to prompt policymakers to revise existing guidelines. This will lead to tangible healthcare access benefits for individuals of all ages and needs. We will also establish networks among ethicists, lawyers, healthcare providers, policymakers, and other stakeholders, fostering continued dialogue to facilitate societal change.

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