Allocation or misallocation of limited medical resources.
Very small premature babies are now kept in neonatal intensive care units for many months to give them a chance at near normal life, but at a cost of up to dollars 1 million. Is that a proper allocation of our finite medical resources (personnel, equipment, supplies, and other necessities) for premies? Or is such action a misallocation of these resources? Both sides of the argument have positive and negative merit. A final philosophical statement is that each human created in the image of God has supreme value. It is it the obligation of fellow humans and society in general to preserve and dignify human life and to care for the total needs of individual citizens to enable them to be healthy and productive members of society. This general principle should help individual physicians make proper microallocation life and death decisions for individual patients and assist governmental bodies responsible for making macroallocation decisions concerning the short- and long-term needs and priorities of the population as a whole. All such decisions should be guided by the basic ethical principles of beneficence, nonmaleficence, autonomy, and justice. However, these principles may at times conflict. For example, if the autonomous rights of the patient conflict with the justice appeals of the community or if beneficence to an individual patient conflict with the needs of another patient, can we deny health care services? By what criteria (merit, potential, effort, achievement, age)? These are difficult if not impossible questions to answer, but they pertain to the topic of this commentary on the allocation of limited medical resources, which is meant to raise the sensitivity of the reader to the complexity of the problem and to raise ethical questions, which are not easily answered or dealt with.
Rosner
Fred
F
Mount Sinai Services at Elmhurst Hospital Center, Elmhurst, New York, USA.
D015276:Health Care Rationing / Q000191:economics / Q000941:ethics*; D006801:Humans; D016377:Organ Transplantation / Q000191:economics / Q000941:ethics; D006435:Renal Dialysis / Q000191:economics / Q000941:ethics; D040841:Resource Allocation / Q000191:economics / Q000941:ethics*