title: Balancing efficiency and need in allocating resources to the care of persons with serious mental illness.
abstract: The care of patients with serious mental illness, for whom a cure is unlikely and costs are high, is difficult to justify using ordinary standards of efficient resource allocation. The author examines the difficulties of using conventional utilitarian, cost-benefit, moral, and political arguments to justify allocation of resources to the care of persons with serious mental illness and offers an alternative approach to this problem based on the goals of medicine. Although care for persons with serious mental illness may not meet the usual standards of efficient health care spending, their treatment is justified by central and long-standing goals of medicine such as relief of pain and suffering and care of those who cannot be cured. This approach suggests that the idea of efficiency in health care spending should be adapted to the goals of medicine rather than making those goals adapt to the idea of efficiency.
authors.affiliation: Hastings Center, Garrison, NY 10524-5555, USA. callahan@thehastingscenter.org
authors.forename: D
authors.initials: D
authors.lastname: Callahan
mesh_terms: D002908:Chronic Disease; D017598:Efficiency, Organizational / Q000592:standards*; D004992:Ethics, Medical; D015276:Health Care Rationing / Q000592:standards*; D006292:Health Priorities; D006301:Health Services Needs and Demand; D006801:Humans; D008134:Long-Term Care / Q000191:economics / Q000592:standards; D001523:Mental Disorders / Q000191:economics / Q000628:therapy; D008605:Mental Health Services / Q000458:organization & administration / Q000600:supply & distribution*; D010166:Palliative Care / Q000191:economics / Q000592:standards; D014481:United States