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Choosing Wisely.

Leonard M Fleck

    Cambridge Quarterly of Healthcare Ethics : CQ : the International Journal of Healthcare Ethics Committees
    |June 28, 2016
    PubMed
    Summary
    This summary is machine-generated.

    Physicians providing more parsimonious care may overlap with healthcare rationing. A public discussion is essential to ensure the justness of cost-control choices in medical treatment.

    Keywords:
    Choosing Wiselydemocratic deliberationdiagnostic uncertaintyhealthcare justicehealthcare rationingmarginal benefitsoverdiagnosisparsimonious care

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    Area of Science:

    • Medical Ethics
    • Health Economics
    • Healthcare Policy

    Background:

    • The American College of Physicians' ethics manual suggested physicians provide care more parsimoniously.
    • This suggestion faced criticism, with opponents viewing it as disguised healthcare rationing.
    • Tilburt and Cassel argued parsimonious care and rationing are ethically distinct.

    Purpose of the Study:

    • To critically assess the claim that parsimonious care and rationing are ethically distinct.
    • To examine the overlap between parsimonious care and rationing in practice.
    • To evaluate the ethical implications of cost-control initiatives in healthcare.

    Main Methods:

    • Critical analysis of ethical arguments regarding parsimonious care and rationing.
    • Comparison of definitions and practical applications of parsimonious care and rationing.
    • Examination of the Choosing Wisely campaign as a case study.

    Main Results:

    • Significant practical overlap exists between parsimonious care and rationing.
    • Initiatives like Choosing Wisely share this overlap.
    • Reducing marginally beneficial, non-cost-effective care necessitates ethical deliberation.

    Conclusions:

    • Parsimonious care and rationing are not ethically distinct in practice.
    • Cost-control measures in healthcare require public discourse on fairness.
    • Ethical justification is crucial for decisions involving resource allocation in medicine.