Ethical aspects of medical economics

The fundamental problem of economics is how best to satisfy human needs and desires in the face of limited resources. Any benefit achieved by expending resources for one purpose is offset by an "opportunity cost": The opportunity to use those resources for other purposes is lost. Whenever resources are used to provide one medical benefit, a choice is made not to provide other benefits. The opportunity costs of medical care choices are rarely acknowledged; thus the ethical implications of such choices are rarely explicitly stated. Rationing of medical care is inevitable; how to ration our resources must be openly debated within an ethical framework. Individual physicians have an ethical obligation to avoid wasteful and unnecessary expenditures of the resources allocated to medical care. Society has an obligation to confront the ethical dilemmas implicit in health care allocation and rationing decisions. Although perhaps less painful, avoiding difficult choices is less ethical than confronting them.