Physicians at the bedside: thoughts and actions with regard to health care allocation

In the past the study of the allocation of scarce medical resources centered around "high-tech" forms of health care, such as the use of the artificial heart and hemodialysis. The use of nonbiomedical criteria (ie, should the social worth or financial status of a particular patient dictate preferential treatment over another patient in times of shortage) in the allocation decision-making process may be at times highly controversial.The study of allocation need not only lie in the dramatic realm of high technology, but should also be directed to the less dramatic, everyday situations. Decisions concerning treatment based upon social worth and financial status are made almost daily by practitioners. A thorough understanding of this phenomenon is tantamount to the ethical and proper practice of medicine.