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PPD SEM 3 > Ethics of distribution > Flashcards

Ethics of distribution Flashcards

1
Q

How much of the taxpayers money is put in the NHS?

A
  • 15% of taxpayers’ money (7.5% of GDP) is invested into the NHS
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2
Q

What happened as a result of the 2007 Comprehensive spending review?

A
  • money for healthcare was prioritised:
  • cleaner hospitals
  • more GP access
  • innovation in the NHS
  • more time
  • more energy
  • more bed spaces
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3
Q

What are the 3 layers of decision making?

A
  • Macro
    = overall, where money will go
    = health, education, defence, social, care
  • Midi
    = how healthcare budget is allocated
    = primary? secondary? paediatrics? resp?
  • Micro
    = paying clinicians
    = how much money spent on each patient
    = who gets which treatment/ transplant etc.
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4
Q

What do you need to think about when allocating resources?

A
  • fair
  • respect autonomy
  • respond to individual need
  • benefiting the whole population
  • autonomy/beneficence/non-maleficence/justice
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5
Q

What is the veil of ignorance?

A
  • John Rawl’s theory
  • random people put in society
  • no one knows their role, class, status, ethnicity, ability etc.
  • the most rational people would choose the society where people who are most disadvantaged are as well off as possible
  • so if they turn out to be disadvantaged they have good treatment
    The
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6
Q

What is stated in the human rights act?

A

o Article 2 – right to life
o Article 8 – right to private life
o Article 12 – right to marriage and children
o Article 14 – prohibition of discrimination (e.g. ageism/sexism)

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7
Q

If you refuse treatment because of advanced age of a person, which articles of the human rights act have you breached?

A
  • Article 2 = ‘right to life’.

- Article 14 = prohibition of discrimination

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8
Q

What are the different approaches to rationing?

A 
o	LIBERTARIANISM - no NHS
o	LOTTERY – luck of draw
o	NEED
o	CONSEQUENTIALISM  
o	PERSONAL RESPONSIBILITY 
o	DEMOCRATIC WAY
o	PLURALISM
o	CONTRACTARIANISM
o	JOHN RAWL’S “ORINIAL POSITION”
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9
Q

What is libertarianism?

A
  • no NHS
  • free market
  • state sohuldn’t play role in healthcare
  • should be down to individual people
  • more private spending
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10
Q

What are the problems with libertarianism?

A
  • can exclude poor people

- process open to discrimination bc of race, genetics, lifestyle

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11
Q

What is lottery?

A
  • allocate resources using lottery

- no discrimination

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12
Q

What are the disadvantages of lottery?

A
  • doesn’t take into account patients needs

- doesn’t look at cost effectiveness

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13
Q

What is need?

A
  • allocate resources according to need
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14
Q

What are the problems with need?

A
  • too subjective
  • what is need?
  • doesn’t look into cost effectiveness
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15
Q

What is consequentialism?

A
  • maximum benefit to society
  • spend resources in a way where max society benefits
    e. g. use QALY TO ASSESS BENEFITS OF TREATMENT
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16
Q

What is QALY?

A
  • Quality Adjusted Life Year.

1 QALY = 1 year of perfect health
= 2 years of half perfect health
= 4 years of quarter perfect health

17
Q

What are the problems of consequentalism?

A
  • putting price on life
  • unethical
  • could basically be discriminitive
  • ignores need of treatment on cost basis
18
Q

What is personal responsibility?

A
  • who is most responsible e.g. for a transplant
  • base decision on choice, lifestyle etc.
  • dont give to ‘irresponsible people’
  • might make people behave properly
19
Q

What is a problem with using personal responsibility?

A
  • doctors may be judgmental/harsh, not all choices are free choices.
20
Q

What is democratic way?

A
  • allocate resources democratic way
21
Q

What are problems associated with democratic way?

A
  • discriminate

- public lack specialist knowledge

22
Q

What is pluralism?

A
  • aspects form democratic, personal responsibility, libertarianism etc. to allocate resources.
  • takes into account complex views
23
Q

What is a problem with pluralism?

A
  • incommensurability

- hard to weigh different values

24
Q

What is contractarianism?

A
  • what reasonable patients would AGREE do

- problem- different thoughts of patients

25
Q

What about JOHN RAWL’S “ORINIAL POSITION”?

A
  • thought about what a just system looks like

- veil of ignorance= most fair society in case we are the weakest, poorest, etc.

PPD SEM 3 (5 decks)

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