title: Ethical issues arising from variation in health services utilization at the end of life.
abstract: Research on health services delivery, particularly at the end of life, has demonstrated that more care does not necessarily lead to better technical quality, patient satisfaction, or outcomes. These findings raise three ethical issues: (1) justice in the allocation of scarce resources across health service areas; (2) nonmaleficence in the provision of appropriate amounts of care to patients; and (3) transparency about local healthcare practice so patients can make enlightened decisions about healthcare choices. We conclude that in this era of healthcare accountability, managers and clinicians can use these ethical principles to drive change in the process of providing more efficient, more effective, and more patient-centered care, especially at the end of life.
authors.affiliation: Dartmouth Institute for Health Policy and Clinical Practice, USA.
authors.forename: William Brinson
authors.initials: WB
authors.lastname: Weeks
authors.forename: William A
authors.initials: WA
authors.lastname: Nelson
mesh_terms: D026686:Beneficence; D003657:Decision Making; D006295:Health Resources; D006302:Health Services Research; D006801:Humans; D007258:Informed Consent; D006278:Medicare; D010166:Palliative Care / Q000191:economics / Q000941:ethics / Q000706:statistics & numerical data; D013727:Terminal Care / Q000191:economics* / Q000941:ethics* / Q000706:statistics & numerical data*; D014481:United States