The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Douglas K. Martin - One of the best experts on this subject based on the ideXlab platform.
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fairness and accountability for Reasonableness do the views of priority setting decision makers differ across health systems and levels of decision making
Social Science & Medicine, 2009Co-Authors: Lydia Kapiriri, Ole Frithjof Norheim, Douglas K. MartinAbstract:Accountability for Reasonableness is an ethical framework for fair priority setting process. This framework has been used to evaluate fairness in several contexts, and a few studies have evaluated its acceptability to decision makers. However, no studies have compared the acceptability of the four conditions of the framework to decision makers across health systems and levels of priority setting. This paper reports the elements of fairness described by 184 decision makers involved in priority setting at the macro-, meso- and micro-levels of priority setting in the Canadian (Ontario), Norwegian and Ugandan health care systems and compares them against the four conditions of 'Accountability for Reasonableness' and across levels of decision making, and health care systems. Our respondents identified 23 elements of fair priority setting. Most of these (17) were well aligned with the four conditions of Accountability for Reasonableness; six were not. Comparisons across health care system and levels of decision making revealed that four elements (transparency, participatory and among the criteria-need based and objective) were common to all and the rest were common to only the health care systems (but not at all levels), or only the levels of decision making (but not to all health are systems). Perceptions varied remarkably across levels of decision making. The overlap between the elements of fairness found in this study and the conditions of Accountability for Reasonableness demonstrates that the four conditions are recognizable and applicable across health care systems and levels of decision making. However, the framework should be used with flexibility to allow for identification of elements and relevant explicit criteria (such as those identified in this study) - that may not directly fit under any of the four conditions.
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what do district health planners in tanzania think about improving priority setting using accountability for Reasonableness
BMC Health Services Research, 2007Co-Authors: Simon Mshana, Jens Byskov, Benedict Ndawi, Haji Shemilu, Roman Momburi, Oystein Evjen Olsen, Douglas K. MartinAbstract:Priority setting in every health system is complex and difficult. In less wealthy countries the dominant approach to priority setting has been Burden of Disease (BOD) and cost-effectiveness analysis (CEA), which is helpful, but insufficient because it focuses on a narrow range of values – need and efficiency – and not the full range of relevant values, including legitimacy and fairness. 'Accountability for Reasonableness' is a conceptual framework for legitimate and fair priority setting and is empirically based and ethically justified. It connects priority setting to broader, more fundamental, democratic deliberative processes that have an impact on social justice and equity. Can 'accountability for Reasonableness' be helpful for improving priority setting in less wealthy countries? In 2005, Tanzanian scholars from the Primary Health Care Institute (PHCI) conducted 6 capacity building workshops with senior health staff, district planners and managers, and representatives of the Tanzanian Ministry of Health to discussion improving priority setting in Tanzania using 'accountability for Reasonableness'. The purpose of this paper is to describe this initiative and the participants' views about the approach. The approach to improving priority setting using 'accountability for Reasonableness' was viewed by district decision makers with enthusiastic favour because it was the first framework that directly addressed their priority setting concerns. High level Ministry of Health participants were also very supportive of the approach. Both Tanzanian district and governmental health planners viewed the 'accountability for Reasonableness' approach with enthusiastic favour because it was the first framework that directly addressed their concerns.
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Priority setting in a hospital drug formulary: a qualitative case study and evaluation.
Health policy (Amsterdam Netherlands), 2003Co-Authors: Douglas K. Martin, Daniel Hollenberg, Sue Macrae, Shannon Madden, Peter SingerAbstract:Dramatically rising costs for new drugs are posing major challenges for hospital budgets. In response to these pressures, hospitals must set priorities for which drugs they will list on their formularies. While there have been studies relevant to decision making in hospitals regarding drugs, none have described how priority setting for drugs in hospitals is done and evaluated it against a framework of how it should be done. In this paper we describe the process of priority setting for new drugs in a hospital formulary and evaluate it using a leading conceptual framework for healthcare priority setting--Daniels and Sabin's 'accountability for Reasonableness'. The findings from this study provide an evidence base for developing strategies to improve this hospital's priority setting regarding its drug formulary. The process we utilized here, describing using case study methods and evaluating using 'accountability for Reasonableness', is a generalizable process for improving the fairness of priority setting in hospital drug formularies.
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fairness accountability for Reasonableness and the views of priority setting decision makers
Health Policy, 2002Co-Authors: Douglas K. Martin, M Giacomini, Peter SingerAbstract:Fairness is a key goal of priority setting and 'accountability for Reasonableness' has emerged as the leading framework for fair priority setting. However, it has not been shown acceptable to those engaged in priority setting. In particular, since it was developed in the context of a primarily privately funded health system, its applicability in a primarily publicly funded system is uncertain. In this paper, we describe elements of fairness identified by decision-makers engaged in priority setting for new technologies in Canada (a primarily publicly funded system). According to these decision makers, accountability for Reasonableness is acceptable and applicable. Our findings also provide refinements to accountability for Reasonableness.
William S Dodge - One of the best experts on this subject based on the ideXlab platform.
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jurisdictional Reasonableness under customary international law the approach of the restatement fourth of foreign relations law
Social Science Research Network, 2019Co-Authors: William S DodgeAbstract:This essay discusses the approach to jurisdictional Reasonableness under customary international law in the Restatement (Fourth) of Foreign Relations Law. The Restatement (Fourth) rejects the Restatement (Third)’s case-by-case approach to Reasonableness, but it does not reject Reasonableness. The Restatement (Fourth) incorporates Reasonableness at the level of customary international law by requiring a “genuine connection” between the subject of the regulation and the State seeking to regulate. The Restatement (Fourth) further incorporates Reasonableness at the level of US domestic law through the presumption against extraterritoriality and the principle of Reasonableness in interpretation, which limit the reach of US law beyond what customary international law requires. Finally, the essay defends the unilateral character of the Restatement (Fourth)’s approach to jurisdictional Reasonableness.
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Reasonableness in the restatement fourth of foreign relations law
Social Science Research Network, 2019Co-Authors: William S DodgeAbstract:This symposium essay compares the different conceptions of Reasonableness in the Restatement (Third) of Foreign Relations Law and the Restatement (Fourth) of Foreign Relations Law. Part I discusses Section 403 of the Restatement (Third), recounting its origins and the subsequent failure of courts in the United States and abroad to embrace its case-by-case approach. Part II describes the principles of Reasonableness found in the Restatement (Fourth), including customary international law’s “genuine connection” requirement, the presumption against extraterritoriality, and the principle of Reasonableness in interpretation. Part III offers a brief evaluation of the different approaches to Reasonableness, concluding that the Restatement (Fourth)’s provison-by-provision approach is preferable.
Annakarin Hurtig - One of the best experts on this subject based on the ideXlab platform.
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improving district level health planning and priority setting in tanzania through implementing accountability for Reasonableness framework perceptions of stakeholders
BMC Health Services Research, 2010Co-Authors: Stephen Maluka, Peter Kamuzora, Miguel San Sebastian, Jens Byskov, Benedict Ndawi, Annakarin HurtigAbstract:In 2006, researchers and decision-makers launched a five-year project - Response to Accountable Priority Setting for Trust in Health Systems (REACT) - to improve planning and priority-setting through implementing the Accountability for Reasonableness framework in Mbarali District, Tanzania. The objective of this paper is to explore the acceptability of Accountability for Reasonableness from the perspectives of the Council Health Management Team, local government officials, health workforce and members of user boards and committees. Individual interviews were carried out with different categories of actors and stakeholders in the district. The interview guide consisted of a series of questions, asking respondents to describe their perceptions regarding each condition of the Accountability for Reasonableness framework in terms of priority setting. Interviews were analysed using thematic framework analysis. Documentary data were used to support, verify and highlight the key issues that emerged. Almost all stakeholders viewed Accountability for Reasonableness as an important and feasible approach for improving priority-setting and health service delivery in their context. However, a few aspects of Accountability for Reasonableness were seen as too difficult to implement given the socio-political conditions and traditions in Tanzania. Respondents mentioned: budget ceilings and guidelines, low level of public awareness, unreliable and untimely funding, as well as the limited capacity of the district to generate local resources as the major contextual factors that hampered the full implementation of the framework in their context. This study was one of the first assessments of the applicability of Accountability for Reasonableness in health care priority-setting in Tanzania. The analysis, overall, suggests that the Accountability for Reasonableness framework could be an important tool for improving priority-setting processes in the contexts of resource-poor settings. However, the full implementation of Accountability for Reasonableness would require a proper capacity-building plan, involving all relevant stakeholders, particularly members of the community since public accountability is the ultimate aim, and it is the community that will live with the consequences of priority-setting decisions.
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decentralized health care priority setting in tanzania evaluating against the accountability for Reasonableness framework
Social Science & Medicine, 2010Co-Authors: Stephen Maluka, Peter Kamuzora, Miguel San Sebastian, Jens Byskov, Benedict Ndawi, Oystein Evjen Olsen, Elizabeth H Shayo, Annakarin HurtigAbstract:Priority-setting has become one of the biggest challenges faced by health decision-makers worldwide. Fairness is a key goal of priority-setting and Accountability for Reasonableness has emerged as a guiding framework for fair priority-setting. This paper describes the processes of setting health care priorities in Mbarali district, Tanzania, and evaluates the descriptions against Accountability for Reasonableness. Key informant interviews were conducted with district health managers, local government officials and other stakeholders using a semi-structured interview guide. Relevant documents were also gathered and group priority-setting in the district was observed. The results indicate that, while Tanzania has a decentralized public health care system, the reality of the district level priority-setting process was that it was not nearly as participatory as the official guidelines suggest it should have been. Priority-setting usually occurred in the context of budget cycles and the process was driven by historical allocation. Stakeholders' involvement in the process was minimal. Decisions (but not the reasoning behind them) were publicized through circulars and notice boards, but there were no formal mechanisms in place to ensure that this information reached the public. There were neither formal mechanisms for challenging decisions nor an adequate enforcement mechanism to ensure that decisions were made in a fair and equitable manner. Therefore, priority-setting in Mbarali district did not satisfy all four conditions of Accountability for Reasonableness; namely relevance, publicity, appeals and revision, and enforcement. This paper aims to make two important contributions to this problematic situation. First, it provides empirical analysis of priority-setting at the district level in the contexts of low-income countries. Second, it provides guidance to decision-makers on how to improve fairness, legitimacy, and sustainability of the priority-setting process.
Peter Singer - One of the best experts on this subject based on the ideXlab platform.
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Priority setting in a hospital drug formulary: a qualitative case study and evaluation.
Health policy (Amsterdam Netherlands), 2003Co-Authors: Douglas K. Martin, Daniel Hollenberg, Sue Macrae, Shannon Madden, Peter SingerAbstract:Dramatically rising costs for new drugs are posing major challenges for hospital budgets. In response to these pressures, hospitals must set priorities for which drugs they will list on their formularies. While there have been studies relevant to decision making in hospitals regarding drugs, none have described how priority setting for drugs in hospitals is done and evaluated it against a framework of how it should be done. In this paper we describe the process of priority setting for new drugs in a hospital formulary and evaluate it using a leading conceptual framework for healthcare priority setting--Daniels and Sabin's 'accountability for Reasonableness'. The findings from this study provide an evidence base for developing strategies to improve this hospital's priority setting regarding its drug formulary. The process we utilized here, describing using case study methods and evaluating using 'accountability for Reasonableness', is a generalizable process for improving the fairness of priority setting in hospital drug formularies.
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fairness accountability for Reasonableness and the views of priority setting decision makers
Health Policy, 2002Co-Authors: Douglas K. Martin, M Giacomini, Peter SingerAbstract:Fairness is a key goal of priority setting and 'accountability for Reasonableness' has emerged as the leading framework for fair priority setting. However, it has not been shown acceptable to those engaged in priority setting. In particular, since it was developed in the context of a primarily privately funded health system, its applicability in a primarily publicly funded system is uncertain. In this paper, we describe elements of fairness identified by decision-makers engaged in priority setting for new technologies in Canada (a primarily publicly funded system). According to these decision makers, accountability for Reasonableness is acceptable and applicable. Our findings also provide refinements to accountability for Reasonableness.
Paul Craig - One of the best experts on this subject based on the ideXlab platform.
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Reasonableness proportionality and general grounds of judicial review a response
Social Science Research Network, 2021Co-Authors: Paul CraigAbstract:In a previous issue of this journal Timothy Endicott authored an article concerning Reasonableness and proportionality as grounds of review in Administrative law. The principal thrust of the article was, as evident from the title, to deny that proportionality could ever be a general ground of judicial review. The tone is forthright, and definitive, as exemplified by phrases such as ‘it is an idea whose time can never come’. The article joins the significant body of literature that explores this topic. Endicott’s central thesis, at least at the outset, is that proportionality can never be a general ground for review, because this is only warranted where there is some qualified right that warrants its application. This is premised on doctrinal and normative argumentation. The doctrinal claim is that neither the UK nor the EU has, or ever had, a general doctrine of proportionality review. The normative claim is that this is explicable principally because the interests of persons affected by administrative decisions do not generally deserve legal protection, and that proportionality is only warranted where a qualified right exists. This article responds to these claims. It begins with elaboration of five foundational tenets that underpin review of discretion, since clarity in this respect is essential to avoid error thereafter. The focus then shifts to proportionality, with discussion of the doctrinal and normative dimensions of the subject. It will be argued that Timothy Endicott’s doctrinal claim is erroneous, insofar as it ignores the fact that in the UK there was a general ground of review for what was termed proportionability, and that the EU has had a general doctrine of proportionality review for at least 50 years. The claim that the time for the emergence of proportionality can never come is thus mistaken in both respects. The normative argument against proportionality as a general head of review is then closely interrogated. It will be seen that the normative claim that only those with a qualified legal right warrant the protection of proportionality review is predicated on two untenable assumptions: that persons affected by administrative decisions do not generally deserve legal protection, and that intervention via proportionality necessarily entails substitution of judgment by the reviewing court and thus is only warranted for those with a qualified legal right. The discussion thereafter elaborates a normative justification for the application of proportionality review in ordinary cases of judicial review that is built on doctrinal reality. The discussion then turns to Timothy Endicott’s analysis of Reasonableness review. It mirrors that of proportionality, insofar as there is a divide between the doctrinal and normative dimensions of the subject. Endicott has two principal doctrinal claims. He contends that Reasonableness review was always open to varying intensity of review, such that it is mistaken to conceive of the Wednesbury test as embodying very limited review that requires the claimant to show that the decision was so unreasonable that no reasonable public body would have reached the contested decision. However, while varying intensity Reasonableness review is now the norm, we should be cautious about regarding Lord Greene MR’s judgment in this manner. He also argues more generally that Reasonableness review should be regarded as part of an anti-arbitrariness doctrine. I am sceptical of any gain from regarding Reasonableness review in this way, since the meaning of an anti-arbitrariness doctrine is unclear, and it does nothing more than reflect substantive conclusions about the scope of judicial review that are arrived at on independent grounds. The focus then shifts to the normative dimension of Reasonableness review. It is unequivocally clear from Endicott’s doctrinal analysis of Reasonableness that he regards the imposition of a disproportionate burden, or disproportionate consideration of one particular consideration as reviewable on grounds of Reasonableness, irrespective of whether there is a qualified legal right or not. This leads to conceptual and normative inconsistency and the unravelling of the central thesis of his article. Proportionality is deemed applicable either where there is a qualified legal right, or even if there is no such right, where a disproportionate burden has been imposed, or there has been disproportionate consideration of a particular interest. The conclusion is reached under the guise of Reasonableness review, but the substantive rationale for intervention is based on proportionality, to which unReasonableness adds nothing other than a conclusory label. There is no explanation as to why proportionality cannot be the ground of intervention, more especially so given that the fact that it fulfilled this doctrinal role without problem in the earlier years of judicial review. This conclusion serves moreover to undermine the argument against proportionality as a general head of review. This is more especially so, when we appreciate the balancing that takes place within Reasonableness review, which is discussed at the end of the article.
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the nature of Reasonableness review
Current Legal Problems, 2013Co-Authors: Paul CraigAbstract:While there is a voluminous literature on proportionality, there is considerably less on Reasonableness as a test for judicial review of discretionary determinations. This paper examines the nature of Reasonableness as a test for judicial review of discretion in UK law. The paper is not predicated on the assumption that Reasonableness always bears the same meaning whenever it is used in constitutional and administrative law in any legal system. Subject to this caveat, it is argued that Reasonableness as a test for judicial review of discretion in UK law is concerned with review of the weight and balance accorded by the primary decision-maker to factors that have been or can be deemed relevant in pursuit of a prima facie allowable purpose; that this is borne out through examination of the case law; that insofar as incommensurability is perceived to be a problem in the context of proportionality then this is also true in relation to Reasonableness review; that the incommensurability problem is less problematic than is commonly perceived; and that a proper appreciation of Reasonableness review has implications for the debate concerning Reasonableness and proportionality as tests for judicial review in administrative law.
