Politics, morality and economics — are there choices?

Abstract

The decision that doctors face as to which patient should be treated by dialysis and which should receive a transplant, is basically not a medical one but a moral one. The doctor’s exercise of clinical judgement is constrained by the lack of money for kidney units. This is the result of a choice regarding spending priorities within the National Health Service (NHS) and between the NHS and other areas of government spending. In turn, this choice is a political decision since politics is about choosing priorities and priorities are determined by political philosophy or, more simply, morality. Because we live in an imperfect world, we must also consider cost effectiveness.