-
Views
-
Cite
Cite
Daniel Strech, Matthis Synofzik, Georg Marckmann, How Physicians Allocate Scarce Resources at the Bedside: A Systematic Review of Qualitative Studies, The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine, Volume 33, Issue 1, February 2008, Pages 80–99, https://doi.org/10.1093/jmp/jhm007
- Share Icon Share
Abstract
Although rationing of scarce health-care resources is inevitable in clinical practice, there is still limited and scattered information about how physicians perceive and execute this bedside rationing (BSR) and how it can be performed in an ethically fair way. This review gives a systematic overview on physicians’ perspectives on influences, strategies, and consequences of health-care rationing. Relevant references as identified by systematically screening major electronic databases and manuscript references were synthesized by thematic analysis. Retrieved studies focused on themes that fell under three major headings: (i) conditions and influences of BSR, (ii) strategies of BSR, and (iii) consequences of BSR. The range of themes indicates that physicians’ rationing behavior is highly variable, strongly influenced by context-related factors, and consists mainly of implicit rationing strategies. Torn between patient advocacy and the obligation to contain costs, physicians experience various role conflicts. The development of explicit rationing strategies seems necessary to avoid arbitrary BSR and allow a fair allocation of health-care resources.