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School of Law

Yvoni Komodromou


PhD Student



Thesis Title

Reviewing medical treatment decisions for people over the age of 65 in England and the US: Looking through a lens of justice


Dr Caroline Morris and Dr Ruth Fletcher


Graduate Teaching Assistant

Summary of Research

Whether justice is being achieved for older individuals in the health care sector is a particularly important issue today. This is especially the case as a rising level of need is becoming more prominent through the ever-increasing ‘elderly’ population and technological developments in medicine. Older patients can contract a number of conditions, demanding more of health care systems. This can create an additional strain on fiscal scarcity that already exists in the health care sector, leading to calls for setting limits on health care entitlements. For this reason, rationing has been given an increasingly important role in decision-making for the allocation of resources, leading to difficult decisions being made.
This thesis analyses the decision-making process for health care resource allocation and assesses the extent to which it attains justice for older patients within the National Health Service of England and the Medicare Program of the United States. Specifically, justice is measured based on Daniels’ extension of the ‘Justice as Fairness’ theory to health care. Through the analysis of the decision-making processes, the rationale behind decisions is identified to see if they are compatible with this theory of justice and to explore the role that law plays in this process.
The thesis approaches the questions through a normative framework, using Daniels’ extension of the ‘Justice as Fairness’ theory to determine whether the decision-making process and the rationale behind such decisions are ‘just’, regarding older individuals. Additionally, the review of these allocation decisions is examined by using the aforementioned theory as a measure to decide whether the process in itself is satisfactory in meeting the principles surrounding the theory. Ultimately, the thesis attempts to examine, through a lens of justice, whether the decision-making process achieves justice for older patients.


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