[Economic and ethical aspects of the development of treatment guidelines]

The introduction of guidelines for diagnosis and therapy involves consequences for medical care which have to be considered both from the perspective of health economics and ethics. Four competing goals of guidelines can be distinguished which are discussed in this paper regarding their economic and ethical plausibility. Guidelines illustrate the fundamental potential and problems of microeconomic evaluations. The strength of these methods is to pursue well defined goals in health economics reliably and efficiently. Problems usually arise if there is no agreement on accepting these goals. The paper intends to show that important theories of a just distribution of health care resources arrive at different goals for guidelines, and recommendations are given to deal with this disagreement.