Date of Award




Document Type

Master's Thesis

Degree Name

Master of Arts (MA)


Department of Philosophy

Content Description

1 online resource (iii, 71 pages) : illustrations.

Dissertation/Thesis Chair

Kristen Hessler

Committee Members

Bonnie Steinbock


Ethics, Philosophy, Public health, Public Policy, Social justice, People with disabilities

Subject Categories

Ethics and Political Philosophy | Philosophy | Public Health


Some patients with chronic disabilities and diseases are able to adapt to their health states and, as a result, rate their quality of life higher than hypothetical patients imagining themselves to be in such states. Due to this phenomenon of adaptation, there is much controversy surrounding the effect of adaptation on patient preferences and the role that these adapted preferences ought to play in health care resource allocation decisions. The process of adaptation affects public health debates about whether we ought to give priority to the worst off in allocation decisions because within traditional public health frameworks, it is unclear whether people who have adapted to their disabilities count as being among those who are worst off, and consequently, deserving of priority. Traditional public health perspectives view adaptation as an intractable dilemma for resource allocation decisions because, utilizing a utilitarian or a prioritarian framework, the criterion they forward for determining public health priorities cannot properly incorporate adapted preferences.