Health Care Analysis

, Volume 12, Issue 2, pp 171–180 | Cite as

An Integrated Approach to Resource Allocation

  • Louise M. Terry

Abstract

Resource allocation decisions are often made on the basis of clinical and cost effectiveness at the expense of ethical inquiry into what is acceptable. This paper proposes that a more compassionate model of resource allocation would be achieved through integrating ethical awareness with clinical, financial and legal input. Where a publicly-funded healthcare system is involved, it is suggested that having an agency that focuses solely on cost-effectiveness leaving medical, legal and ethical considerations to others would help depoliticise rationing decisions and command greater public acceptance.

decision-making model macro-allocation medical-social triage resources 

REFERENCES

  1. Alexander, M. (1999, February, 18) Real Democracy Demands a Willingness to Listen to Genuine Local Voices. Health Service Journal, p.19.Google Scholar
  2. BBC News. (2002) Outrage Over Blindness Guidelines. Http://news.bbc.co.uk/hi/english/health/ newsid 2041000/2041525.stmGoogle Scholar
  3. Bell, A. (2000) It's Not Fair: Issues of Equity in NHS Health Care. British Journal of Health Care Management 6(12), 580–581.Google Scholar
  4. Black, M., and Mooney, G. (2002) Equity in Health Care from a Communitarian Standpoint. Health Care Analysis 10, 193–208.Google Scholar
  5. Blumstein, J.F. (1997) The Oregon Experiment: The Role of Cost-Benefit Analysis in the Allocation of Medicaid Funds. Social Science Medicine 45(4), 545–554.Google Scholar
  6. British Medical Association. (2001) Healthcare Funding Review. London: BMA.Google Scholar
  7. Butler, J. (1999) The Ethics of Health Care Rationing: Principles and Practices. London: Cassell.Google Scholar
  8. Campbell, A., Charlesworth, M., Gillett, G., and Jones, G. (1997) Medical Ethics (2nd edn.). Oxford: Oxford University Press.Google Scholar
  9. Campbell, T. (1999) Human Rights: A Culture of Controversy. Journal of Law and Society 26(1), 6–26.Google Scholar
  10. Devlin, B. (2003, March) The Ethical Option. Health Management, pp. 10–12.Google Scholar
  11. Dickenson, D. (1999) Can Medical Criteria Settle Priority-Setting Debates? The Need for Ethical Analysis. Health Care Analysis 7, 131–137.Google Scholar
  12. Dixon, J., and Welch, H.G. (1991) Priority Setting: Lessons from Oregon. The Lancet 337, 891–894.Google Scholar
  13. Dworkin, R. (2000) Sovereign Virtue: The Theory and Practice of Equality. London: Harvard University Press.Google Scholar
  14. Harris J. (1997) The Case Against: What the Principal Objective of the NHS Should Really Be. BMJ 314, 669–672.Google Scholar
  15. Harris, J. (1999) Justice and Equal Opportunities in Health Care. Bioethics 13(5), 392–404.Google Scholar
  16. Highland NHS Board. (2002) Ethical Decision Making: A Framework for Ethical governance. Inverness, Scotland, UK Highland NHS Board.Google Scholar
  17. Holt, S. (2002, June, 19) Letters: Beyond belief. Daily Mail.Google Scholar
  18. Jonsen, A.R. (1990) The New Medicine and the Old Ethics. London: Harvard University Press.Google Scholar
  19. Jonsen, A.R., Siegler, M., and Winslade, W.J. (1998) Clinical Ethics: A Practical Approach to Ethical Decisions in Clinical Medicine (4th edn.). New York: McGraw Hill.Google Scholar
  20. Kennedy, I. (Chair) (2001) Bristol Royal Infirmary Inquiry Final Report. London: The Stationery Office.Google Scholar
  21. Klein, R. (1993) Dimensions of Rationing: Who Should Do What Next? BMJ 307, 309–311.Google Scholar
  22. Klein, R., Day, P., and Redmayne, S. (1996) Managing Scarcity: Priority Setting and Rationing in the National Health Service. Oxford: Oxford University Press.Google Scholar
  23. Kluge, E.-H.W., and Tomasson, K. (2002) Health Care Resource Allocation: Complicating Ethical Factors at the Macro-Allocation Level. Health Care Analysis 10, 209–220.Google Scholar
  24. Kuczewski, M.G. (1997) Fragmentation and Consensus: Communitarian and Casuist Bioethics. Washington, DC: Georgetown University Press.Google Scholar
  25. Loewy, E.H. (1999) Justice and Health Care Systems: What Would an Ideal Health Care System Look Like? Health Care Analysis 6, 185–192.Google Scholar
  26. Mannion, R., and Small, N. (1999) Postmodern Health Economics. Health Care Analysis 7, 255–272.Google Scholar
  27. Marsh, B. (2000, May, 6) Ordeal for Thousands Over Breast Cancer Drug. Daily Mail.Google Scholar
  28. Millar, B. (1999, March, 18) Race Against Time. Health Service Journal, pp. 9–10.Google Scholar
  29. National Institute for Clinical Excellence. (2000) Press Release: NICE Issues Guidance on Taxanes for Ovarian Cancer (NICE 2000/013). London: NICE.Google Scholar
  30. National Institute for Clinical Excellence. (2002a) Final Appraisal Determination: Photodynamic Light Therapy for Age-Related Macular Degeneration (2002/033). London: NICE.Google Scholar
  31. National Institute for Clinical Excellence. (2002b) Press Statement 2002/033 NICE has Not Issued Guidance or Recommendations to NHS on Photodynamic Therapy. London: NICE.Google Scholar
  32. Romanow, R.J. (Commissioner) (2002) Building on Values: The Future of Health Care in Canada: Final Report. Ottawa: Commission on the Future of Health Care in Canada.Google Scholar
  33. Stoll, B.A. (Ed.). (1989) Ethical Dilemmas in Cancer Care. Basingstoke, UK: Macmillan.Google Scholar
  34. Subramanian, K.N., and Paul, V.K. (1995) Care of Critically Ill Newborns in India. Journal of Legal Medicine 16, 263–275.Google Scholar
  35. Weir, R.F. (1989) Abating Treatment with Critically Ill Patients: Ethical and Legal Limits to the Medical Prolongation of Life. New York: Oxford University Press.Google Scholar

Copyright information

© Kluwer Academic Publishers 2004

Authors and Affiliations

  • Louise M. Terry
    • 1
  1. 1.Faculty of Health, Essex CampusLondon South Bank UniversityLondonUnited Kingdom

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