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Fair Resource Allocation and Rationing at the Bedside$
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Marion Danis, Samia A. Hurst, Len Fleck, Reidun Forde, and Anne Slowther

Print publication date: 2014

Print ISBN-13: 9780199989447

Published to Oxford Scholarship Online: November 2014

DOI: 10.1093/acprof:oso/9780199989447.001.0001

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PRINTED FROM OXFORD SCHOLARSHIP ONLINE (www.oxfordscholarship.com). (c) Copyright Oxford University Press, 2019. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use. date: 21 September 2019

Give to the Doctor What Is Due to the Doctor!

Give to the Doctor What Is Due to the Doctor!

Why “Fair Rationing at the Bedside” Is Impossible

(p.253) 15 Give to the Doctor What Is Due to the Doctor!
Fair Resource Allocation and Rationing at the Bedside

Vegard Bruun Wyller

Oxford University Press

Clinical decision making might be based on moral principles focusing exclusively on the individual patient, such as the principles of beneficence, autonomy, and nonmaleficence. Alternatively, clinical decisions might include considerations in which the individual patient is seen in relation to others. Such considerations draw upon the moral principles of justice or solidarity and knowledge from health economics. The dilemmas of priority are confined to the latter alternative. This chapter, however, elaborates the negative side effects of a clinical practice that pays increased attention to prioritizing and less to the classical, individually focused virtues. Three fundamental premises constitute a starting point for the discussion: (a) that prioritizing always implies general moral considerations, (b) that prioritizing usually concerns the total usage of resources in society, not only the health budget; and (c) that prioritizing, given points (a) and (b), principally belongs to the political sphere.

Keywords:   clinical decision making, moral principles, beneficence, autonomy, nonmaleficence, justice, solidarity, priority setting, political sphere

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