Ethics and The Allocation of Health-Care Resources  

Oleh:

Breen, Kerry J. ; Cordner, Stephen M. ; Thomson, Colin J. H. ; Plueckhahn, Vernon D.

Jenis: Article from Books - E-Book
Dalam koleksi: Good Medical Practice Professionalism, Ethics and Law, page 195-207.
Topik: Decision Making; Resource Allocation; Health-Care Resources
Fulltext: Ethics and The Allocation of Health-Care Resources.pdf (140.63KB)

Isi artikel

Autonomy, bene?cence, non-male?cence and justice are four of the basic principles upon which ethical medical practice is founded (see Chapter 1). In the allocation of health-care resources, be it at government, institutional or medical practitioner level, the principle of justice, particularly ‘distributive justice’, is central. In 1990, the National Health and Medical Research Council (NRMRC) in the Discussion Paper on Ethics and Resource Allocation said: In the allocation of any public resources our concern should be primarily with justice. This involves giving to each person his or her due. In allocating health care resources our concern is largely with distributive justice – to distribute amongst members of the community those bene?ts and burdens due to them. The basis of distributive justice is the notion of fairness. The most appropriate criterion for a fair distribution of resources would appear to be those of equity and need. More speci?cally, a just allocation should offer equal treatment for those whose needs are similar. In other words, each person is entitled to enjoy an appropriate share of the sum total of the resources available according to their need. However, the need which justi?es one person’s entitlement must be a need which can be ful?lled in a way compatible with ful?lling the similar needs of others. [1] Modern society stresses that arbitrary discrimination between people with the same needs cannot be morally justi?able. Questions about the ethical justi?cation of priorities in the provision of medical care are pressing relentlessly on the medical profession, the government and society as a whole [2–3]. Most developed countries have introduced changes to health-care funding and delivery in attempts to make health care more ef?cient, most noticeably and controversially the introduction of managed care in the USA. In many countries these changes have been resisted by the medical profession. One result has been that the medical profession has excluded itself from the debates and decision making. More recently the profession has sought to put itself ‘back onto the political map of health’ [4] under the guise of claiming renewed ‘medical professionalism’

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