This chapter discusses the concept of need in palliative care and the macroallocation and microallocation of health-care resources. The process of resource allocation comprises two separate functions. Macroallocation is the process of deciding how much money should be spent and how it will be obtained, what kind of services should be available and to which population, who will provide the services, and how the power to control them will be distributed. Microallocation is the process of deciding which individuals from the population requiring the service should actually receive it. Health-care resources should be allocated and used so as to maximize benefit and distribute that benefit justly. Morally justifiable selection criteria for specialist care are patient need, differential likelihood of benefit or success from interventions and from the process of care, opportunity cost, and prior commitment.
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