Available online 22 February 2024, 105031

There is an urgent need to delimit the tasks of healthcare

Healthcare demands and options by far outrun available resources.

What should have priority; to reduce suffering or promote wellbeing?

Main positions in ethics and social science provide answers.

We have stronger moral obligations towards other persons’ suffering than their wellbeing.

Suffering should have priority to wellbeing in priority setting

What do we owe other persons? Are we as much obliged to promote their wellbeing as we are to reduce their suffering? This question is crucial for a range of social institutions and welfare services, and especially for the health services. To address this question the article investigates prominent positions and arguments in moral philosophy. It finds that while classical utilitarianism claims that there is symmetry in the moral obligation with respect to peoples’ wellbeing and their suffering, a wide range of other positions and perspectives argue for an asymmetric relationship with stronger moral obligations towards other persons’ suffering than towards their wellbeing. This difference in obligations is supported ontologically by basic differences inherent in wellbeing and suffering and axiologically by a relative (gradual) difference in value. The many well-founded arguments for stronger moral obligations towards other persons’ suffering than towards their wellbeing has important implications for health policy; especially for priority setting. Avoiding and reducing suffering should have priority to the promotion and enhancement of wellbeing.

wellbeing

suffering

asymmetry

obligation

moral appeal

© 2024 The Author. Published by Elsevier B.V.