Book contents
- Frontmatter
- Foreword
- Contents
- List of tables
- Preface
- Preface to the 1997 edition
- Acknowledgments
- About the authors
- Table of cases
- Table of statutes
- 1 Ethical principles for the medical profession
- 2 Ethical and legal responsibilities of medical students
- 3 Communication skills
- 4 Consent and informed decision making
- 5 Confidentiality, privacy and disclosure
- 6 Medical records, reports and certificates
- 7 Negligence, professional liability and adverse events
- 8 The regulation of the medical profession
- 9 Health care complaints systems
- 10 The doctor and sexual boundaries
- 11 Personal health of the doctor: illness and impairment
- 12 Maintenance of professional competence
- 13 Ethics and the allocation of health-care resources
- 14 The Australian health-care system
- 15 The doctor and interprofessional relationships
- 16 Entering and leaving practice and practice management
- 17 Clinical research
- 18 Prescribing and administering drugs
- 19 Diagnosing and certifying death and the role of the coroner
- 20 Births, reproductive technology, family law and child protection
- 21 Termination of pregnancy and related issues
- 22 Withholding or withdrawing treatment in the seriously or terminally ill
- 23 The law and the mentally ill
- 24 The law and courts of law in Australia
- 25 Medico-legal examinations and reports, court procedures and expert evidence
- 26 Other legislation relevant to medical practice
- APPENDIX 1 AMA CODE OF ETHICS – 2004
- Index
- References
This chapter is part of a book that is no longer available to purchase from Cambridge Core
13 - Ethics and the allocation of health-care resources
Book contents
- Frontmatter
- Foreword
- Contents
- List of tables
- Preface
- Preface to the 1997 edition
- Acknowledgments
- About the authors
- Table of cases
- Table of statutes
- 1 Ethical principles for the medical profession
- 2 Ethical and legal responsibilities of medical students
- 3 Communication skills
- 4 Consent and informed decision making
- 5 Confidentiality, privacy and disclosure
- 6 Medical records, reports and certificates
- 7 Negligence, professional liability and adverse events
- 8 The regulation of the medical profession
- 9 Health care complaints systems
- 10 The doctor and sexual boundaries
- 11 Personal health of the doctor: illness and impairment
- 12 Maintenance of professional competence
- 13 Ethics and the allocation of health-care resources
- 14 The Australian health-care system
- 15 The doctor and interprofessional relationships
- 16 Entering and leaving practice and practice management
- 17 Clinical research
- 18 Prescribing and administering drugs
- 19 Diagnosing and certifying death and the role of the coroner
- 20 Births, reproductive technology, family law and child protection
- 21 Termination of pregnancy and related issues
- 22 Withholding or withdrawing treatment in the seriously or terminally ill
- 23 The law and the mentally ill
- 24 The law and courts of law in Australia
- 25 Medico-legal examinations and reports, court procedures and expert evidence
- 26 Other legislation relevant to medical practice
- APPENDIX 1 AMA CODE OF ETHICS – 2004
- Index
- References
Summary
Autonomy, beneficence, non-maleficence 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 benefits 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 specifically, 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 justifies one person's entitlement must be a need which can be fulfilled in a way compatible with fulfilling the similar needs of others.
Modern society stresses that arbitrary discrimination between people with the same needs cannot be morally justifiable.
- Type
- Chapter
- Information
- Good Medical PracticeProfessionalism, Ethics and Law, pp. 195 - 207Publisher: Cambridge University PressPrint publication year: 2010
References
. Discussion Paper on Ethics and Resource Allocation in Health Care. Australian Government Publishing Service, Canberra, 1990.Google Scholar
, . Managing medical resources. Return to the commons?JAMA 2007; 297: 2518–21.CrossRefGoogle ScholarPubMed
, , et al. Clinical ethicists' perspectives on organisational ethics in health-care organizations. J Med Ethics 2008; 34: 320–3.CrossRefGoogle Scholar
. Doctors in Society: Medical Professionalism in a Changing World. Royal College of Physicians, UK, 2005.Google Scholar
. Medical professionalism in the new millennium: a physicians' charter. Med J Aust 2002; 177: 263–5.Google Scholar
. Medical professionalism: is it really under threat?Med J Aust 2007; 186: 596–8.Google ScholarPubMed
. The patient–doctor relationship in the new millennium: adjusting positively to commercialism and consumerism. Clinics in Dermatology 2001; 19: 19–22.CrossRefGoogle ScholarPubMed
, . Teaching medical students about fair distribution of health care resources. J Med Ethics 2007; 33: 737–41.CrossRefGoogle Scholar
. Retracing the Oregon trail: the experience of rationing and the Oregon plan. BMJ 1998; 316: 1965–9.CrossRefGoogle Scholar
, , et al. Impact of the Oregon Health Plan on access and satisfaction of adults with low income. Health Services Research 2002; 37: 11–31.Google ScholarPubMed
, , . ‘These sorts of people don't do very well’: race and allocation of health care resources. J Med Ethics 1995; 21: 356–60.CrossRefGoogle ScholarPubMed
, . Health-care Allocation: An Ethical Framework for Public Policy. Linacre Centre, London, 2001.Google Scholar
, , . The secret art of managing health-care expenses: investigating implicit rationing and autonomy in public health-care systems. J Med Ethics 2007; 33: 704–7.CrossRefGoogle Scholar
, , . Seeing the NICE side of cost-effectiveness analysis: a qualitative investigation of the use of CEA in NICE technology appraisals. Health Econ 2007; 16: 179–93.
, . Managing Medical Resources: return to the Commons?JAMA 2007; 297: 2518–21.CrossRefGoogle ScholarPubMed
. Declaration of Geneva (revised 2006). http://www.wma.net/e/policy/c8.htm
AMA Code of Ethics – 2004 (editorially revised 2006). http://www.ama.com.au/codeofethics
. Code of Professional Conduct. http://www.nswmb.org.au/index.pl?page=44
. Good Medical Practice. http://www.medicalboard.qld.gov.au/resources/index.html
, 2005. http://www.rcpsc.medical.org/canmeds/CanMEDS2005/index.php
.The medical profession and the pharmaceutical industry – when will we open our eyes?Med J Aust 2004; 180: 409;3–10.Google ScholarPubMed
. Combating disease mongering: daunting but nonetheless essential. PLoS 2006; 3(4): e146.Google ScholarPubMed
. Protecting the medical commons: who is responsible?N Eng J Med 1975; 293: 235–41.CrossRefGoogle ScholarPubMed
. Why saying no to patients in the United States is so hard: cost containment, justice, and provider autonomy. N Eng J Med 1986; 314: 1380–3.CrossRefGoogle ScholarPubMed
, , et al. Physicians' views on resource availability and equity in four European health care systems. BMC Health Serv Res 2007; 31: 137.CrossRefGoogle Scholar
, , et al. Prevalence and determinants of physician bedside rationing: data from Europe. J Gen Intern Med 2006; 21: 1138–43.CrossRefGoogle ScholarPubMed
High Technology Medicine: Benefits and Burdens. Oxford University Press, Oxford, 1986.Google Scholar
, , . ‘Not clinically indicated’: patients' interests or resource allocation. BMJ 1993; 306: 379–81.CrossRefGoogle ScholarPubMed
, . A framework for rationing by clinical judgment. Kennedy Inst Ethics J 2007; 17: 247–66.CrossRefGoogle ScholarPubMed
. Simple rationality? The law of health-care resource allocation in England. J Medical Ethics 2007; 33: 404–7.CrossRefGoogle ScholarPubMed
US state legislatures kept busy with managed care issues. Lancet 1996; 347: 1545.CrossRefGoogle Scholar
, (eds). Philosophy and Medical Welfare. Cambridge University Press, Cambridge, 1988.
Just Health: Meeting Health Needs Fairly. Cambridge University Press, Cambridge, 2008.Google Scholar
Who Lives? Who Dies? Ethical Criteria in Patient Selection. Yale University Press, New Haven, 1990.Google Scholar
. Ethics of resource allocation. In: , , (eds). Surgery, Ethics and the Law. Blackwell Science Asia, Carlton South, 2000.Google Scholar
(ed.). Rationing Health Care. Churchill Livingstone, London, 1995.
. Rationing health care: the ethics of medical gatekeeping. J Contemp Health Law Policy 1986; 2: 23–45.Google Scholar
, , . Principles for allocation of scarce medical interventions. Lancet 2009; 373: 423–31.CrossRefGoogle ScholarPubMed