Ethics of Resource Allocation Flashcards
Why has the need for rationing resources increased?
Shift from acute illness to chronic, long term illnesses
normal physiological events have been medicalised
Increase in choice and increase in expensive drugs
etc.
What are the three allocation theories?
Egalitarian principles
Maximising principles
Libertarian principles
What is meant by egalitarian principles?
Aristotelian equality/justice
The NHS was founded on a requirement to provide all care that is necessary and appropriate to everyone. Allowing for equal access
What is the challenge to the egalitarian principles?
tension between the egalitarian aspirations and finite resources. Not enough to go around everyone, so can it really be equal?
What is meant by maximising principles?
Criteria in order to maximise public utility
What is the challenge faced by maximising principles?
Who decides the criteria??
What is meant by libertarian principles?
each person is responsible for their own health, wellbeing, and fulfilment of life plan
What is an example of a libertarian principle process?
German health incentive life plan (e.g. they get incentives for attending routine health checks)
What are the leading risk factors to disease in high income countries?
Tobacco BP Alcohol cholesterol Overweight Low fruit + veg intake Physical inactivity Illicit drug use Unsafe sex
What may motivate unhealthy behaviour?
Costs of unhealthy activities impact future but the benefits occur in the present
Challenge of affluence to self control
Social networks - obesity
Backwards looking vs forwards looking
What are the considerations for whether an individual could be held accountable for their current and future health?
- person who is unwell or in poor health cannot exercise their political and civil rights
- obligation to help others in need, regardless of the causation, provided that helping would not impose unacceptable sacrifice on others
- Establishing causality between behaviour and need for treatment is often uncertain or impossible
- Justified inequalities (smoking), moralistic judgements (eating or exercise habits)
- A persons productivity Is influenced by many factors, which the person has little control over
- ? measuring the value of contribution
What are the twin injunctions of the Hippocratic Canon?
To do good
To do no harm
What does the Hippocratic Canon apply to?
Individual patients as well as systems that sustain human health to both current and future generations
