Ethics, priorities and cancer

Beginning with the ethical case for maximising the impact of health care resources on health, this article examines nine arguments for exempting cancer treatments from rigorous economic evaluation or for relaxing some of the conditions often required if an intervention is to be provided at public expense. Some of these may have validity under particular circumstances but, in general, if these arguments apply at all they apply also to other treatments for similarly placed patients (for example, those near the end of their lives) and so do not constitute an argument for treating cancer patients as such more favourably than others. The arguments need to be more than merely valid. They need also to have quantitative and qualitative significance.