Bergen senter for etikk og prioritering (BCEPS)


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Severity and Priority Setting in Health Care - SEVPRI

SEVPRI is based at the Health Services Research Unit at Akershus University Hospital (HØKH), where it is led by Senior Researcher Mathias Barra. BCEPS is a collaborative partner and host for one of the project's three PhD research fellowships.

SEVPRI overview
SEVPRI - Conceptual Illustration



The aim of SEVPRI is to achieve a better public discussion about priority setting. It is about understanding how peoples’ values impact their views on priority setting in health care, and about translating this into criteria for priority setting that achieve the ideal of democratic, open, and fair priority setting in health care.

The duty to first direct resources to the most severely ill appears widespread, and many health jurisdictions today employ a 'severity' criterion. These criteria are often interpreted as a counterbalance to the cost-per-Quality Adjusted Life-Year (QALY) criterion; a utilitarian criterion. But, what does severity really mean in this context? The academic literature does not contain clear answers, and the public debate reveals very different views on this issue.

SEVPRI sets out to improve on this state. By gauging the public’s subjective views on severity and fairness with qualitative and quantitative methods, and subjecting these views to analysis by a multidisciplinary team including leading philosophers, economists, psychologists and physicians, we will characterise the public's various views about what severity and fairness means to people by systematically mapping these views to ethical theories. We will also ascertain which non-utilitarian concerns can be integrated within the utilitarian QALY-models, and analyse the moral tensions between discovered ethical values.

The most critical phases of SEVPRI are data-acquisition – when our researchers will enter in a dialogue with the public through country-wide workshops – and the dissemination of our outcomes to a wide audience of citizens, policy makers and politicians. With an impressive team, with expertise and experience that will help to surmount these challenges, SEVPRI will change how philosophers think about severity, how health economists construct their formalisms, and how we speak about priority setting both as citizens, as health professionals and as policy makers.

Public Participation

SEVPRI wishes to come into contact with members of the public to find out more about the meaning of "severity". If you would like to take part in a discussion on severity with other project participants and SEVPRI researchers, you can register your interest here (in Norwegian): Registration of interest

Seminar Series

A SEVPRI Seminar Series on the Philosophy of Priority Setting is being planned for the first Tuesday in each month.

  1. Tuesday 2 March
    "Social Egalitarianism and Health – Implications for Priority Setting"
  2. Tuesday 6 April
    "Defining Premature Death: Concepts, measures, and normative validity"
  3. Tuesday 4 May
    "Is there support for having patient benefit as an independent criteria for priority setting - when taking into account severity and cost-effectiveness?"
  4. Tuesday 1 June
    "Severity, Age and the Relevance View"
  5. Tuesday 7 September
    "The severity of well-treated severe illness"
  6. Tuesday 5 October
    "Absolute QALY shortfall operationalisation of severity for use in health technology assesment in Norway"
  7. Tuesday 2 November
    "Analysing longevity through the lens of lifespan inequality"
  8. Tuesday 7 December

Time: 11:00 - 12:30 (30 minutes presentation + 60 minutes discussion)