Last Chance Therapies and Managed Care: Pluralism, Fair Procedures, and Legitimacy

Hastings Center Report 28 (2):27-42 (1998)
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Abstract

How can health plans make fair determinations about when “experimental” (and costly) treatments such as high dose chemotherapy with autologous bone marrow transplantation should be covered despite lack of clear clinical consensus about their benefits? Different models for managing “last chance” therapies evolving in some health plans offer promising examples of how issues of fairness and legitimacy in decisionmaking can be addressed.

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