Ethics - Resource allocation

From CambridgeNotes

Theories on resource allocation

  • Cost-effectiveness utilitarian analysis (quality adjusted life years or QALYs measure quality and quantity) but…
    • Welfare not only value e.g. difficult to justify a hospice
    • Unjust because do not take into account those experiencing them e.g. person with handicap less likely to qualify for help than someone without
    • Calculation of "quality" problematic
  • Needs theory: some pt have special claim because of their particular NEEDs

Other factors that may affect priority

  • Age: fair-innings argument (QALYs not explicitly ageist)
  • Responsibility for condition affecting priority: consequences of choices versus factors influencing choice
  • Social factors e.g. dependent children, benefit to society such as health care (!)

Rationing and Law

  • Healthcare provider needs to explain decision in 2 ways:
    • Was the procedure for making the decision reasonable?
    • Were the grounds for making decision reasonable?
  • May be challenged:
    • Public law: that NHS failed in statutory duty to improve the health of people
    • Private law: person or institution negligent in decision (doesn’t directly affect future resource management)
    • Recently nurse invoked the human rights act
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