Burden attribution governs who carries the costs that choices and institutions create. It generalizes burden allocation from the individual case to the structural one, and its rule is a matter of placement, not worth: a cost should land as close as reasonably possible to the jurisdiction that generates it, rather than being exported onto participants who had no part in it — the same logic the accounting boundary applies to ecological transfer. Where a choice exports cost, the mechanisms are ordinary ones: taxes, regulation, prevention, and limits on exposing others.
The decisive constraint is what attribution may never become. Someone who smokes may face taxes, restrictions on exposing others, and — when a medical resource is genuinely scarce, such as an organ or an intensive-care bed, — allocation that weighs prognosis or expected benefit, all without losing healthcare standing. The question is never are they less deserving? but how much of a self-created burden can fairly be transferred to others?
Consequences should attach to the burden where feasible, not to the worth of the participant.
Ordinary care is pooled for everyone. Owned scarce goods are a different matter: health counts there only as the claimant’s own testimony.