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USING PRACTICE GUIDELINES TO ALLOCATE MEDICAL TECHNOLOGIES

An Ethics Framework

Published online by Cambridge University Press:  25 May 2001

Mita K. Giacomini
Affiliation:
McMaster University
Deborah J. Cook
Affiliation:
McMaster University
David L. Streiner
Affiliation:
McMaster University and Baycrest Centre for Geriatric Research
Sonia S. Anand
Affiliation:
McMaster University

Abstract

Clinical practice guidelines are expanding their scope of authority from clinical decision making to collective policy making, and promise to gain ground as resource allocation tools in coming years. A close examination of how guidelines approach patient selection criteria offers insight into their ethical implications when used as resource allocation or rationing instruments. The purposes of this paper are: a) to examine the structure of allocative reasoning found in clinical guidelines; b) to identify the ethical principles implied and compare how guidelines enact these principles with how explicit systems-level rationing exercises and health policy analyses have approached them; and c) to offer some preliminary suggestions for how these ethical issues might be addressed in the process of guideline development. The resulting framework can be used by guideline developers and users to understand and address some of the ethical issues raised by guidelines for the use of scarce technologies.

Type
Research Article
Copyright
© 2000 Cambridge University Press

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USING PRACTICE GUIDELINES TO ALLOCATE MEDICAL TECHNOLOGIES
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