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An ethical framework for rationing health care.
1Department of Medical History and Ethics, School of Medicine, University of Washington, Seattle 98195.
The Journal of Medicine and Philosophy
|February 1, 1992
Summary
This study proposes an ethical framework for rationing healthcare, emphasizing equitable access to basic services and limiting non-basic care. It suggests using medical benefit as a criterion for rationing non-basic healthcare services.
Area of Science:
- Bioethics
- Health Policy
- Public Health
Background:
- Rationing of publicly-financed healthcare is a complex ethical challenge.
- Existing rationing criteria lack a consistent ethical foundation.
- Balancing resource allocation with principles of justice is crucial in healthcare.
Purpose of the Study:
- To propose an ethical framework for rationing publicly-financed healthcare.
- To classify and analyze ethical arguments for various rationing criteria.
- To establish principles for a just healthcare system.
Main Methods:
- Classification of rationing criteria based on their ethical underpinnings.
- Examination of ethical arguments for specific rationing approaches.
- Development of a framework for equitable healthcare resource allocation.
Main Results:
- Identified four key rationing criteria: high-technology services, non-basic services, least medical benefit, and unequal availability.
- Argued against limiting basic healthcare based on ability to pay.
- Proposed limiting non-basic healthcare, ensuring equal access to basic care, and using medical benefit for non-basic care rationing.
Conclusions:
- A just healthcare system must guarantee basic healthcare for all, irrespective of ability to pay.
- Rationing of non-basic healthcare is ethically permissible under specific conditions.
- Equality in access to basic healthcare and reliance on medical benefit for non-basic care are key components of healthcare justice.