The Problems With Rule-Based Rationing  

Oleh:

Hall, Mark A.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The Journal of Medicine and Philosophy vol. 19 no. 4 (Aug. 1994), page 315-332.
Topik: Bedside Rationing; Costs-Constraint; Rule-Based Rationing

Ketersediaan

Perpustakaan Pusat (Semanggi) Nomor Panggil: MM80.3 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Centralized, democratic rules are often asserted as a superior basis for rationing than individualized physician disretion. This article counters this prevailing wisdom by exploring the deficiencies of rule-based rationing. Rules are too imprecise to accurately reflect all the nuances of physical and mental impairment and the complexity of medical science, particularly considering the widely varying personal values that different patients attach to medical risk and benefit. Rule-based rationing also suffers from the biasing effects of interest group pressure on political processes and the tendency to absolve physicians from any moral responsibility for the rationing decisions they implement. Internalizing cost constraints is a more socially and professionally acceptable means of rationing and, in any event, it is inevitable since even a preponderance of rule-based rationing will leave considerable areas of discreation for physician judgment in the implementation and interpretation of the rules. As a consequences, despite the flaws of bedside rationing, it is foolhardly to dispense with it entirely in favor of an exclusively rule-based system.

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