Lecture 5 - Rationing Health Care Flashcards
What are the 2 main qualities for deciding the allocation of health care services?
Efficiency
Equity
Why is modern public health controversial?
Public health interventions may go against accepted ethical principles
Difficult to resolve obligations citizens have towards maintains their own health
What factors are public health interventions driven by?
Utilitarianism
Paternalism
Social responsibility
What are potential ethical implications for public health interventions?
May involve changes in groups or individuals
Programmes create tension
What makes a health care system fair?
Universal access
Access without excessive burdens
Fair distributions of financial costs
Education and training of healthcare providers
Cost effective use of results of medical research and high quality research
What is rationing??
Finding and justifying a reason for limiting the allocation of scarce resources to some but not all potential beneficiaries
What are some examples of rationing?
-Denial through lack of resources
-Restriction of resource to a certain quantity per person or treatment modality
-Restricted allowance for all but the option to pay for extra resources
What are some ethical considerations when rationing medical resources?
Maximise welfare (how benefical?)
How do we determine morally relevant reasons for treating people differently
Patient autonomy
Euiqty and fairness
Social determinants of health
Why do we need rationing?
Finite resources vs infinite demand
Increasing demands (costs and expectations)
Comprehensiveness (sacrifice availability for quality?)
What is the main ethical issue with rationing healthcare?
What are the 2 main ethical principles that need to be considered?
Conflict between justice and beneficence
What are the principles of justice?
Fair equitable treatment
Right to a minimum of healthcare
Distributive justice = fair equitable and appropriate distribution of resources
Formal justice = equals must be treated equally regardless
Material justice = needs based in clinical need
What is the utilitarian theory of justice? ((nto exmianed)
A mixture of criteria to Maximise public and health utility
What is the libertarian theory of justice? (not examined)
Emphasise rights to social and economic liberty
What is the communitarian theory of justice? (not examined)
Stress practices off justice that come from shared traditions and values in a community
Why are QALYs (Quality Adjusted Life Years) useful to help with rationing?
What are its problems?
Concentrates on medical utility (how effective a treatment will be)
Doesnt do well with commorbidities
Possibly ageist
