Resource Allocation Flashcards
What are the pros of the age/ fair innings argument?
Those of a certain age (75) have had a fair share of life so don’t warrant public resources if they become ill
Value of life remains equal regardless of age
What are the cons of the age/fair innings argument?
Cut off age?
Ignores value of prognosis
Ageism may infiltrate other areas of healthcare
Devalues lives of older people
What are the pros of the social worth argument?
The members of society who’ve contributed more are more deserving of medical care
People with dependents worthier: state will need to care for orphaned children; children’s lives blighted by parents’ death
What are the cons of the social worth argument?
Who decides who is worthy?
Biased against disabled
Other family members can look after children; everyone who dies will have family whose lives are blighted
What are the pros of the personal responsibility argument?
Those with self-inflicted illnesses are less deserving of medical treatment
What are the cons of the personal responsibility argument?
Factors beyond our control: upbringing, education, social background, genes
We must be consistent: would society accept withdrawing treatment from mountaineers, workaholics?
Imposing personal prejudices: anti-smoking etc.
What are the pros of the justice argument?
All people have a right to health care and therefore an equal claim to healthcare
What are the cons of the justice argument?
Not realistic; must be resource allocation
What is morally special about healthcare?
What are the pros of the QALY’s/utilitarian approach?
Treatments with the best cost-benefit ratio should have priority
Maximises utility
What are the cons of the QALY’s/Utilitarian approach?
Biased against disabled people (QALYs will always be worse in these people)
Ageist (less QALYs to gain)
Don’t distinguish between life saving and life improving treatments
Preference scores are subjective (derived from healthy people, not those living with impairment)
Equates quality of life with value of life
What are the pros of the public opinion argument?
Ask the public to find out what people view as important health priorities
What are the cons of the public opinion argument?
Conditions that evoke less sympathy/are rare get defunded/changing priorities
Some vulnerable groups do not have a strong advocate
What are the pros of the EBM argument?
Using clinical evidence to decide what Rx to provide on basis of effectiveness
What are the cons of the EBM argument?
Setting threshold for effectiveness
Biased towards medical perspective (e.g. life years gained) and not PT perspective (QOL)
Deprioritises interventions where little research is done
Prioritises interventions where lots of research is done
Industry bias: more research goes into pharm than non-pharm interventions
What are the pros of the personal choice argument?
Give individuals the money to invest in personal health insurance plan (informed by FH, RFs)
Pro: May opt for cosmetic surgery instead of expensive Rx like dialysis / ITU
