Resources have always been inadequate for food, economics and healthcare and all scarce resources are rationed in one way or another. Healthcare resources can be in the forms of medicine, machinery, expensive treatment and organ transplantation. For decades, allocation of healthcare resources in an equitable manner has always been the subject of debate, concern and analysis, yet the issue has persistently resisted resolution. Scarcity of resources for healthcare and issue of allocation is permanent and inescapable (Harris, “Deciding between Patients”). Scarcity can be defined in general, in emergency and in crises as well as shortage of certain kind of treatment, medicine or organs. As a result of scarcity of resources, and some people may be left untreated or die when certain patients are prioritized and intention of is that everyone will ultimately be treated (Harris, 2009: 335). Allocation of limited resources is an ethical issue since it is vital to address the question of justice and making fair decisions. Ethical judgments and concerns are part of daily choice in allocation of health resources and also to ensure these resources are allocated in a fair and just way. This paper will explore how QALYs, ageism and responsibility in particular influence the allocation of healthcare resources in general through the lens of justice, equity, social worth, fairness, and deservingness.
A quality-adjusted life year (QALYs) is one of the most widely used measures for measuring the quality of life and is used for the assessment of health outcomes. Health is a function of length of life and quality of life (Prieto and Sacristán, 2003) and this measure serves as composite indicator which allows quantity and quality of life in a single ind...
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Harris, John. “Deciding between Patients.” A Companion to Bioethics, Second Edition (2009): 333–350. Print.
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Companion to Bioethics, Second Edition (2009): 351-61. Blackwell Publishing. Print.
On the topic of Atul Gawande’s novel Being Mortal: Medicine and What Matters in the End, an ongoing issue has brought into question what we should do with the elderly and ill that are in need of care. On the one hand, some argue that they should be put in nursing homes and seek treatment for their problems because they can no longer take care of themselves. From this perspective, the elderly have a greater chance of getting injured if they are not taken care of properly, thus are seen as unfit to live on their own. On the other hand, however, others argue that the elderly should be allowed to live on their own as long as they maintain a healthy lifestyle. Atul Gawande, one of this view’s main proponents, urges us to realize that no one is immortal
When situations arise and people die or become ill a value has to be placed on their life to determine if they are going to be healed or if their family is going to be compensated for their loss. The value of life has a variety of interpretations based on the approach a person decides to take. Some people think of human life with an economic point of view which can led to certain deceased citizens receiving more money for accidents than others. The economic view also says that if a surgery is going to cost the government to much money then the person who needs the surgery should not get it. On the other hand, some people look at it emotionally and say that everyone should get an equal amount of money for incidents that occur. People who look
Primarily, it is important to clarify Daniels’ views on the allocation of health care. As said in Lewis Vaughn’s Bioethics
Tom Harpur, in his 1990 article in the Toronto Star - "Human dignity must figure in decisions to prolong life" - presents numerous arguments in support of his thesis that the use of advanced medical technology to prolong life is often immoral and unethical, and does not take into consideration the wishes of the patient or their human dignity. However, it must be noted that the opening one-third of the article is devoted to a particular "human interest" story which the author uses to illustrate his broader argument, as well as to arouse pity among readers to support his view that human life should not always be prolonged by medical technology. This opening section suggests that a critical analysis of Harpur 's arguments may find widespread use of logical fallacies in support of the article 's thesis. In this essay I will argue that, given how greatly
“The only real nation is humanity” (Farmer 123). This quote represents a huge message that is received in, Tracy Kidder’s, Mountains Beyond Mountains. This book argues that universal healthcare is a right and not a privilege. Kidder’s book also shows the audience that every individual, no matter what the circumstances, is entitled to receive quality health care. In the book Kidder represents, Paul Farmer, a man who spends his entire life determined to improve the health care of impoverished areas around the world, namely Haiti, one of the poorest nations in the world. By doing this the audience learns of the horrible circumstances, and the lack of quality health care that nations like Haiti live with everyday, why every person has the right to healthcare no matter what, and how cost effectiveness should not determine whether or not these people get to live or die. Two texts that also argue this idea are Monte Leach’s “Ensuring Health Care as a Global Human Right,” and Darshak Sanghavi’s “Is it Cost Effective to Treat the World’s Poor.” Leach’s article is an interview with Benjamin Crème that illustrates why food, shelter, education, and healthcare are human rights that have to be available to everyone. He shares many of the same views on health care as Farmer, and the two also share similar solutions to this ongoing problem. Leach also talks about the rapidly growing aids epidemic, and how it must be stopped. Like farmer, he also argues that it is easier to prevent these diseases then to cure them. Furthermore, Sanghavi’s article represents many of the questions that people would ask about cost effectiveness. Yet similar to Farmer’s views, Sanghavi argues that letting the poor d...
...th professionals, were significantly more cynical toward and distrustful of older adults” (p. 63). The findings in Meisner’s (2012) conveyed that physicians demonstrated attitudes about older patients including feelings of these individuals being “disengaged and unproductive” while assuming that these characteristics applied to all of the older patients regardless of each person’s actual abilities (p. 63). Combing all older adults into one category defined by disability and dysfunction is detrimental to the well-being of each patient. Chronological age is not the determining factor relative to treatment; functional age is a better testament to expected outcomes for a patient. It is imperative that physicians understand what is “normal aging” rather than searching for pathologies based on symptoms that are just part of this aging process. According to Meisner
In this diverse society we are confronted everyday with so many ethical choices in provision of healthcare for individuals. It becomes very difficult to find a guideline that would include a border perspective which might include individual’s beliefs and preference across the world. Due to these controversies, the four principles in biomedical ethic which includes autonomy, beneficence, non-maleficence and justice help us understand and explain which medical practices are ethical and acceptable. These principles are not only used to protect the rights of a patient but also the physician from being violated.
She also highlights the driving forces such as money and profit oriented market, pointing to the demands of increasingly sophisticated medical technology by the very few with the " most buying power. This need stems from an important to human rights and reflecting the Christian teachings principle of autonomy. As she recognizes it as an important in the recognition of human value principle, she does not want it to be the only one to be valued. She speaks of the importance of affecting our and the world 's policies allowing the preferential option for the poor and fulfilling our Christian obligations to love our neighbor. She also speaks of the common good such as health care, and its just distribution. Taking care of the poor, and the just distribution of the common good are the principles that should be valued. After all, as Mahatma Gandhi once said; "The greatness of a nation is measured by how it cares for its most vulnerable
The just delivery of health care falls into a pattern of rights. Medicaid and the US political view aside, the right to health care is a basic human right whose only requirement is that someone be a human being regardless of their gender, ethnicity, or socioeconomic class. That is, the right is a non-relational right that every human needs irrespective of differences in individual goals (Lomasky, 1981). As a positive right, it is the obligation of others to provide for one’s health needs, within limits. In satisfying the right to health care, society contributes toward the fulfillment of the right for the individual. In Medicaid for example, the right is supported through taxation, among other mechanisms and delivered by a
Theories concerned with ageing are constructed in an attempt to objectively satisfy the inquiries that arise after studying ageing and to provide evidence based clarifications. In the context of this essay, they allow troubleshooting regarding issues around the type of support would be expected to be needed by Betty and her son. Bengtson et al, (1999) accepts the potential pragmatism of the theories nevertheless he argues that they can be generalised and unimaginative. The controversy regarding theorising ageing becomes especially relevant when they are applied in isolation failing to address that “the science and positivism are severely limiting… for understanding aspects of ageing.” Bengtson et al (1999)
According to DeBrew, author of “Can being ageist harm your older adult patients?” stereotypes and discrimination are evident in various aspects of patient care. “Ageism [is] defined as stereotyping or discrimination aimed at older adults and a lack of knowledge about normal changes of aging and presentation of illness in older adults (. . .)” (DeBrew, 2015). DeBrew (2015) states, “research findings suggest that ageism is common in healthcare” (DeBrew, 2015). Ageism is not only an issue in the healthcare setting, but also among older adults as well as their families. When ageism is present in the healthcare setting it poses
To conclude, health care is a primary responsibility of governments. They have to make sure that everybody has a total insurance which ensures equality between all members of the society with no segregation between rich and poor. Marxist theory mentioned that medicine became a profitable project more than a human task to serve people and save their lives as it was linked to capitalism. John, the poor factory man was guilty for doing such a sever action to keep hostages but at the same time he wasn’t guilty to be poor and didn’t have an insurance to save his son’s life. Physician role is to be fair when dealing with patients and to think of morals and ethics of the profession before thinking of money.
Thank you for your insightful evaluation and responses to the questions presented this week. As you stated, health care rationing often takes many shapes and forms. Organ allocation is an excellent example of current health care rationing. In fact, Rossoff (2014), who is a professor of pediatrics and medicine at Duke University Medical Center and the director of clinical ethics at Duke University Hospital, also noted organ allocation as a current form of health care rationing in his book titled Rationing is Not a Four-letter Word: Setting Limits on Health Care.
Today, medical interventions have made it possible to save or prolong lives, but should the process of dying be left to nature? (Brogden, 2001). Phrases such as, “killing is always considered murder,” and “while life is present, so is hope” are not enough to contract with the present medical knowledge in the Canadian health care system, which is proficient of giving injured patients a chance to live, which in the past would not have been possible (Brogden, 2001). According to Brogden, a number of economic and ethical questions arise concerning the increasing elderly population. This is the reason why the Canadian society ought to endeavor to come to a decision on what is right and ethical when it comes to facing death. Uhlmann (1998) mentions that individuals’ attitudes towards euthanasia differ. From a utilitarianism point of view – holding that an action is judged as good or bad in relation to the consequence, outcome, or end result that is derived from it, and people choosing actions that will, in a given circumstance, increase the overall good (Lum, 2010) - euthanasia could become a means of health care cost containment, and also, with specific safeguards and in certain circumstances the taking of a human life is merciful and that all of us are entitled to end our lives when we see fit.
The objective of this project shall identify the extent to which the principle of equity underpins government strategy in contemporary Irish health policy. In order to examine this principle, the essay will focus on the health services for older people. Such services are an important topic to address in modern day Irish society because the population of those aged over 65 is set to increase considerably which will cause particular economic and social implications for healthcare services in the future. Initially the paper shall provide a foundation of historical developments that have emerged within the Irish Healthcare system and highlight social policy implementations that have occurred. Following this, the paper will go on to discuss 'equity' with emphasis placed on the importance of effective policy measures to safeguard the equity and fair treatment of the elderly within the Irish healthcare system. Inference shall be made to the medical card scheme, hospital bed waiting lists, services for elderly people and the equity issues involving public and private healthcare. It shall also examine government policy papers in terms of how the two-tiered health system shows evidence of inequality that goes against the code of equity sought out by the `Quality and Fairness' (2001) report. Finally this essay will finish with a conclusion of the overall discussion.