title: The ethics of rationing.
abstract: Rationing can occur at three levels of health care choice: the individual, the institutional and the social, with each level posing its own ethical problems. The institutional level is the focus of this paper. The principle of effectiveness may seem attractive, since it promises to ease the institutional dilemmas of rationing, but it is not straightforward to implement in the face of uncertainty. Greater efficiency also promises much, but concepts of benefit are contested and improving contractual performance has complications. Fairness can be a powerful criterion, but there are contested cases, for example age, where its meaning is unclear. Democratic responsiveness, for all its difficulties, is important to maintain in whatever process of rationing is chosen and this can be done by adopting some procedural devices.
authors.affiliation: Department of Government, University of Essex, Colchester, UK.
authors.forename: A
authors.initials: A
authors.lastname: Weale
mesh_terms: D003657:Decision Making; D004992:Ethics, Medical; D015276:Health Care Rationing / Q000592:standards*; D006292:Health Priorities; D006295:Health Resources / Q000600:supply & distribution; D006297:Health Services Accessibility; D006801:Humans; D013222:State Medicine; D016896:Treatment Outcome; D006113:United Kingdom