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The values and ethical commitments of doctors engaging in macroallocation: a qualitative and evaluative analysis
Siun Gallagher1, Miles Little2, Claire Hooker3
1Faculty of Medicine and Health, Sydney Health Ethics, Medical Foundation Building K25, University of Sydney, Sydney, NSW, 2006, Australia. siun.gallagher@sydney.edu.au.
BMC Medical Ethics
|July 26, 2018
Summary
Doctors
Area of Science:
- Bioethics
- Health Systems Research
- Medical Ethics
Background:
- Formal processes manage resource scarcity in socialized health systems.
- Doctors act as technical experts in health priority setting.
- Ethical issues arise from doctors' participation in macroallocation.
Purpose of the Study:
- Describe doctors' values and ethical commitments in priority setting.
- Identify an ethical framework for doctors' macroallocation work.
- Contribute empirically derived insights to health resource allocation.
Main Methods:
- Semi-structured interviews with 20 doctors involved in Australian health system macroallocation.
- Grounded moral analysis methodology, an iterative empirical bioethics approach.
- Interchange between ethical and empirical to support normative claims.
Main Results:
- Doctors' common values span personal ethics, justice, and argumentation.
- Participants' insights align with Paul Ricoeur's 'little ethics' framework.
- Doctors' good in macroallocation is linked to 'good life' with others in just institutions.
Conclusions:
- Doctors' values impact health macroallocation procedurally and substantively.
- Challenges assumption of doctors being solely deontologically motivated.
- Identified an ethical framework grounded in doctors' values and distributive justice intuitions.
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