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

Patients’ 'best interests' are important in healthcare, but their use faces challenges: - Resource allocation: As well as aggregate measurements like population health, healthcare resource allocation should be sensitive to individual patients' claims.

The idea of best interests provides limited guidance here, since resource constraints mean we cannot promote everyone's best interests. - Value disagreement: Caring for patients who cannot communicate preferences – including infants – often generates fundamental value disagreement between carers and medical professionals over their best interests.

My proposal explores whether a principle of sufficiency - the idea that it is particularly important to prevent people from being very badly off - can help.

Sufficiency has received renewed attention in political philosophy; my research will build on recent theoretical advances, developing a theory that is responsive and applicable to practical challenges.

Goals - Systematically outline challenges to best interests and existing work on sufficiency; - Generate a novel sufficiency-based approach that can be used in healthcare decisions; - Consider challenges and develop recommendations for two related practical issues: resource allocation and the care of critically ill infants; - Publish 12 peer-reviewed journal articles; - Disseminate research findings via websites and public-engagement activity at Oxford; - Host a workshop on the role of sufficiency in healthcare.