Societal duty and resource allocation for persons with severe traumatic brain injury

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Abstract
Among the most difficult issues in bioethics is social justice in the allocation of limited resources among needy subpopulations. Resource allocation decisions involving persons with traumatic brain injury are perhaps the most difficult of all, due, in part, to the extraordinary resource needs of persons with brain injury and the inability of many such individuals to express their preferences and desires. This article considers eight values and factors that enter into decisions regarding resource allocation for persons with brain injury. These factors include views on (1) the quality and meaning of life, (2) the moral culpability of the brain-injured person for his or her condition, (3) the social contribution of a person with a brain injury, (4) the allocation of family and societal responsibilities, (5) the concept of justice, (6) the type of justice being sought in a given situation, (7) the nature of health care, and (8) the efficacy of specific medical and rehabilitative interventions. This article concludes by offering ideas about how some of the polarization on resource allocation issues can be averted.

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