Prioritization not Rationing in Cancer Care

  • Nikolaus KnoepfflerEmail author
  • Jürgen Zerth
  • Martin O’Malley
Part of the Recent Results in Cancer Research book series (RECENTCANCER, volume 213)


Conditions of scarcity impact healthcare services for cancer patients. This is the unpleasant reality for nations, local governments, hospitals, and even individual doctors. This means that medical services judged by objective standards as potentially effective by medical professionals are limited because of financial or access scarcity. With this situation of scarcity as premise, one must raise the ethical question of how to deal with scarcity while respecting fundamental principles of human dignity and human rights. This chapter focuses on the German healthcare context where dignity and rights form the basis and framework for medical ethics. Accordingly, in Germany, rationing medical services for life-threatening diseases has been traditionally and appropriately criticized and prohibited. Granting a situation of scarcity, however, some prioritization becomes increasingly necessary. Thus, there is present need for careful ethical analysis of non-emergency regulatory prioritization principles and protocols. Above all, analysis and conclusions must preserve and foster society’s deepest moral commitments.


Prioritization Rationing Human dignity Ethics Oncology Scarcity of resources Healthcare 



Jan Schildmann, Wilhelm Löhe Hochschule, Fürth, Germany, Eefje Barber, Fockbek, Germany


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Nikolaus Knoepffler
    • 1
    Email author
  • Jürgen Zerth
    • 2
  • Martin O’Malley
    • 1
  1. 1.Friedrich Schiller UniversityJenaGermany
  2. 2.Wilhelm Löhe HochschuleFürthGermany

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