 The ethics of health care allocation or rationing raises a raft of issues that are not directly dependent on the potential discriminatory impact on persons with disabilities. Yet, since it is difficult to clearly separate the general ethical issues from those raised by the focus on disability, we begin in Section 1 by surveying, first, general ethical concerns in health care rationing, and then the specific issues raised by CEA and quality of life as a metric of the “benefit” that health care resources provide. We then turn in Section 2 to review why it has been argued that disability poses a special set of ethical issues in health care rationing. The ethical issues of health resource rationing (or “prioritization” as it is sometimes called) can be exemplified either at the individual level of specific allocation decisions “at the bedside”, or more generally as a social policy of health care rationing. The ethical issues at the individual level are reviewed in Section 2, and social policy issues are considered in Section 3, including whether it makes any difference if access to health care is viewed as a human right. We conclude in Section 4 with the unsatisfactory result that we remain in a dilemma: refusing to consider disability in health care allocation seems irrational and unfair, but taking disability into account raises a range of, apparently, irresolvable philosophical issues.