Priority setting in health care is ubiquitous and health authorities are increasingly recognising the need for priority setting guidelines to ensure efficient, fair, and equitable resource allocation. While cost-effectiveness concerns seem to dominate many policies, the tension between utilitarian and deontological concerns is salient to many, and various severity criteria appear to fill this gap. Severity, then, must be subjected to rigorous ethical and philosophical analysis. Here we first give a brief history of the path to today’s severity criteria in (...) Norway and Sweden. The Scandinavian perspective on severity might be conducive to the international discussion, given its long-standing use as a priority setting criterion, despite having reached rather different conclusions so far. We then argue that severity can be viewed as a multidimensional concept, drawing on accounts of need, urgency, fairness, duty to save lives, and human dignity. Such concerns will often be relative to local mores, and the weighting placed on the various dimensions cannot be expected to be fixed. Thirdly, we present what we think are the most pertinent questions to answer about severity in order to facilitate decision making in the coming years of increased scarcity, and to further the understanding of underlying assumptions and values that go into these decisions. We conclude that severity is poorly understood, and that the topic needs substantial further inquiry; thus we hope this article may set a challenging and important research agenda. (shrink)

Transdisciplinary research knits together knowledge from diverse epistemic communities in addressing social-environmental challenges, such as biodiversity loss, climate crises, food insecurity, and public health. This paper reflects on the roles of philosophy of science in transdisciplinary research while focusing on Indigenous and other subaltern forms of knowledge. We offer a critical assessment of demarcationist approaches in philosophy of science and outline a constructive alternative of transdisciplinary philosophy of science. While a demarcationist focus obscures the complex relations between epistemic communities, transdisciplinary (...) philosophy of science provides resources for meeting epistemic and political challenges of collaborative knowledge production. (shrink)