title: Medical decision making in scarcity situations.
abstract: The issue of the allocation of resources in health care is here to stay. The goal of this study was to explore the views of physicians on several topics that have arisen in the debate on the allocation of scarce resources and to compare these with the views of policy makers. We asked physicians (oncologists, cardiologists, and nursing home physicians) and policy makers to participate in an interview about their practices and opinions concerning factors playing a role in decision making for patients in different age groups. Both physicians and policy makers recognised allocation decisions as part of their reality. One of the strong general opinions of both physicians and policy makers was the rejection of age discrimination. Making allocation decisions as such seemed to be regarded as a foreign entity to the practice of medicine. In spite of the reluctance to make allocation decisions, physicians sometimes do. This would seem to be only acceptable if it is justified in terms of the best interests of the patient from whom treatment is withheld.
authors.affiliation: Department of Public Health, Erasmus MC, Rotterdam, Netherlands. jjmvandelden@jc.azu.nl
authors.forename: J J M
authors.initials: JJ
authors.lastname: van Delden
authors.forename: A M
authors.initials: AM
authors.lastname: Vrakking
authors.forename: A
authors.initials: A
authors.lastname: van der Heide
authors.forename: P J
authors.initials: PJ
authors.lastname: van der Maas
mesh_terms: D000328:Adult; D000367:Age Factors; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003657:Decision Making / Q000941:ethics*; D005260:Female; D015276:Health Care Rationing / Q000941:ethics*; D006291:Health Policy; D006801:Humans; D008017:Life Expectancy; D008020:Life Support Care / Q000941:ethics; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010820:Physicians / Q000523:psychology*; D011050:Policy Making; D011287:Prejudice; D011788:Quality of Life; D040841:Resource Allocation / Q000941:ethics*; D009927:Tissue and Organ Procurement / Q000941:ethics