title: [Mixing of medical and scientific responsibilities is undesirable].
abstract: Should the medical responsibility to provide good care and the societal responsibility to allocate scarce resources remain separated or be brought together? Bonneux takes the latter position. Guidelines would offer an appropriate tool for this: the consensus groups developing them can at the same time take into account medical knowledge and a just distribution of resources. There are arguments against this view: consensus groups do not have the status and legitimation to take allocative decisions. Such decisions should be made at the political level, the more so since they affect individual entitlements to care under health insurance legislation. If cost effectiveness plays a dominant role in their development, guidelines can no longer be regarded as a true reflection of the professional standard of care. Finally, doctors cannot and should not be exempted from legal liability on the sole ground that they act in accordance with a guideline.
authors.affiliation: Afd. Sociale Geneeskunde, Academisch Medisch Centrum/Universiteit van Amsterdam.
authors.forename: J K
authors.initials: JK
authors.lastname: Gevers
mesh_terms: D003362:Cost-Benefit Analysis; D017048:Health Care Costs; D006291:Health Policy; D006297:Health Services Accessibility / Q000191:economics*; D006801:Humans; D009426:Netherlands; D011050:Policy Making; D017410:Practice Guidelines as Topic / Q000592:standards*; D017009:Professional Autonomy