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[Criteria for an ethically adequate prioritisation of individualised treatment strategies]
Sebastian Schleidgen1, G Marckmann1
1Institut für Ethik, Geschichte und Theorie der Medizin, München.
Objectives:
In view of the constant increase of biomedical innovations as well as the demographic change an explicit regulation of health services is inevitable in the German health-care system. Particularly, this applies to so-called individualised treatment measures, which so far only rarely show significant advantages over "classical" treatment measures with mostly substantially higher costs. Against this background, appropriate prioritisation criteria are developed and possibilities as well as limits of their application in the context of individualised medicine are shown.
Methods:
The prioritisation criteria are derived in an analytically ethical manner.
Results:
Based on a basic need-oriented approach of an ethically adequate health care, five prioritisation criteria have been developed: badness/gravity, entrenchment, urgency, benefit and cost-benefit ratio.
Conclusions:
The relative weight of the criteria in individual cases cannot be derived in a purely analytical manner but needs to be determined through fair political decision-making processes. Furthermore, empirical data are necessary in order to interpret and weigh the criteria in prioritisation decisions. In the context of individualised treatment strategies benefit assessment is of special interest.
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