Adam Ehlert

Prioritization among patients is an inherent and unavoidable aspect of all healthcare systems, involving the allocation of limited resources such as time, funding, personnel, and facilities. While this issue is universal, not all jurisdic-tions have established legal frameworks guiding how such prioritizations should be conducted. In Sweden, the Parliament enacted a statutory ethical platform in 1997 intended to inform healthcare prioritization decisions, based on three guiding principles: the principle of human dignity, the principle of need and solidarity, and the principle of cost-effectiveness. This article examines the legal and ethical dimensions of prioritization in Swedish healthcare, with particular attention to how decisions are made, by whom, and on what grounds. Despite the formal existence of the ethical plat-form, the actual processes and models used for prioritization remain opaque, and the interpretation and application of the principles vary significantly across healthcare levels.We argue that consistent and transparent prioritization practices are essential for maintaining the legitimacy and trustworthiness of the healthcare system. Accordingly, this study aims to clarify the content of the ethical platform and to identify the practical challenges involved in its implementation. Drawing on both legal analysis and medical ethics, the article investigates the operational context of prioritization in contemporary Swedish healthcare and seeks to contribute to the development of more coherent, transparent, and legally robust prioritization frameworks.

This article discusses the relationship between two theories about the badness of death, the Life-Comparative Account and the Gradualist Account, and two methods of operationalizing severity in health care priority setting, Absolute Shortfall and Proportional Shortfall. The aim is that theories about the badness of death can influence and inform the idea of the basis of severity as a priority setting criterion. I argue that there are strong similarities between the Life-Comparative Account and Absolute Shortfall, and since the Life-Comparative Account is one of the most reasonable accounts of the badness of death, this provides some support for using Absolute Shortfall. I also argue that it is difficult to find support for Proportional Shortfall from theories about the badness of death, and also, that it is difficult to find support for Gradualist Account from theories about severity.