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rdf:type |
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lifeskim:mentions |
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pubmed:issue |
4
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pubmed:dateCreated |
1999-1-13
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pubmed:abstractText |
After establishing that it is essential that health care be rationed in some fashion, the paper examines the arguments for and against clinicians as gatekeepers. It first argues that bedside clinicians do not have the information needed to make allocation decisions. Then it claims that physicians at the bedside can be expected to make the wrong choice for two reasons: their commitment to the Hippocratic ethic forces them to pursue the patient's best interest (even when resources will produce only very marginal benefit and could do much more good elsewhere) and their values will lead them to calculate the net value of treatments incorrectly. Alternative decision makers are considered. It is argued that both groups of physicians and administrators will also make allocations incorrectly and that leaving the allocation decisions to patients themselves is the best approach. Mechanisms for fair and efficient rationing by patients at the societal and individual level are examined.
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pubmed:keyword |
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pubmed:language |
eng
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pubmed:journal |
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pubmed:citationSubset |
E
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pubmed:status |
MEDLINE
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pubmed:month |
Dec
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pubmed:issn |
1054-6863
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pubmed:author |
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pubmed:issnType |
Print
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pubmed:volume |
7
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pubmed:owner |
KIE
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pubmed:authorsComplete |
Y
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pubmed:pagination |
391-401
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pubmed:dateRevised |
2004-11-18
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pubmed:meshHeading |
pubmed-meshheading:11655372-Administrative Personnel,
pubmed-meshheading:11655372-Altruism,
pubmed-meshheading:11655372-Beneficence,
pubmed-meshheading:11655372-Conflict of Interest,
pubmed-meshheading:11655372-Cost-Benefit Analysis,
pubmed-meshheading:11655372-Decision Making,
pubmed-meshheading:11655372-Delivery of Health Care,
pubmed-meshheading:11655372-Economics,
pubmed-meshheading:11655372-Ethical Theory,
pubmed-meshheading:11655372-Ethics,
pubmed-meshheading:11655372-Gatekeeping,
pubmed-meshheading:11655372-Goals,
pubmed-meshheading:11655372-Health Care Rationing,
pubmed-meshheading:11655372-Health Promotion,
pubmed-meshheading:11655372-Humans,
pubmed-meshheading:11655372-Life Support Care,
pubmed-meshheading:11655372-Managed Care Programs,
pubmed-meshheading:11655372-Medicine,
pubmed-meshheading:11655372-Organizational Policy,
pubmed-meshheading:11655372-Patient Advocacy,
pubmed-meshheading:11655372-Patient Participation,
pubmed-meshheading:11655372-Patients,
pubmed-meshheading:11655372-Physician's Role,
pubmed-meshheading:11655372-Physicians,
pubmed-meshheading:11655372-Public Policy,
pubmed-meshheading:11655372-Quality of Health Care,
pubmed-meshheading:11655372-Quality of Life,
pubmed-meshheading:11655372-Resource Allocation,
pubmed-meshheading:11655372-Social Justice,
pubmed-meshheading:11655372-Social Responsibility,
pubmed-meshheading:11655372-Treatment Outcome,
pubmed-meshheading:11655372-United States,
pubmed-meshheading:11655372-Value of Life,
pubmed-meshheading:11655372-Withholding Treatment
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pubmed:year |
1997
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pubmed:articleTitle |
Who should manage care? The case for patients.
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pubmed:publicationType |
Journal Article
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