Ethics and Waiting Times: Incorporating theories of justice in an analysis of waiting times in Sweden

Sammanfattning: Objectives: There is growing concern regarding waiting times in health care as a mechanism to improve fairness in health services. This essay addresses the issue by evaluating fairness defined by justice theories. Based on this discussion, the essay then investigates whether actual waiting times are consistent with ethical principles. Theory: The theories of justice discussed are utilitarianism, egalitarianism and maximin. The discussion reveals that analysis of waiting times may better capture fairness objectives by incorporating these ethical principles. Quantitative Analysis and Results: Swedish waiting times 2011-2017 were analysed, where the public priority-setting guidelines were evaluated in terms of ethical principles. A fixed effects model and descriptive statistics found that actual waiting times only partially correspond to the guidelines. Conclusions: The 'fairness' of waiting times depends on how it is defined by justice theories and official guidelines. Future research may build on the incorporation of justice theories into waiting time analysis or strengthen the econometric analysis.