Objective Personalized medicine is an increasingly prominent approach in many disease areas, including oncology and rare (genetic) disorders, but is often associated with high costs. The development of effective but (very) expensive medical treatments leads to discussions about whether and how such treatments should be allocated in solidarity-based universal access healthcare systems. In such discussions, the concept of solidarity is often used, but considered elusive. What does it mean?
Method We have conducted a conceptual analysis of the concept of solidarity as it is used in the literature on the allocation and funding of expensive medical treatments.
Results In this presentation, we identify and discuss four uses of the concept of solidarity: 1) the assistance of patients in need, 2) the upholding of the universal access healthcare system, 3) the willingness to contribute, and 4) the promotion of equality. We distinguish normative and descriptive uses of the concept, and analyze the overlap and differences between the concepts of solidarity and justice. Our analysis shows that the various uses of the concept of solidarity point to different, even conflicting, ethical stances on whether and how access to effective, expensive treatments should be provided.
Conclusion Although the concept of justice may serve as the decisive principle in the allocation of healthcare resources, solidarity does have a role to play in discussions on funding of expensive medical treatments, requiring, for instance, that healthcare policies promote and maintain societal willingness to contribute to the care of others and the value of assisting patients in need.
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