A framework for rationing by clinical judgment

Kennedy Institute of Ethics Journal 17 (3):247-266 (2007)

Authors
Samia Hurst
University of Geneva
Abstract
: Although rationing by clinical judgment is controversial, its acceptability partly depends on how it is practiced. In this paper, rationing by clinical judgment is defined in three different circumstances that represent increasingly wider circles of resource pools in which the rationing decision takes place: triage during acute shortage, comparison to other potential patients in a context of limited but not immediately strained resources, and determination of whether expected benefit of an intervention is deemed sufficient to warrant its cost by reference to published population based thresholds. Notions of procedural justice are applied along with an analytical framework of six minimal requisites in order to facilitate fair bedside rationing: (1) a closed system that offers reciprocity, (2) attention to general concerns of justice, (3) respect for individual variations, (4) application of a consistent process, (5) explicitness, and (6) review of decisions. The process could be monitored for its applicability and appropriateness.
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DOI 10.1353/ken.2007.0021
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Why Physicians Ought to Lie for Their Patients.Nicolas Tavaglione & Samia A. Hurst - 2012 - American Journal of Bioethics 12 (3):4-12.
Healthcare Rationing Cutoffs and Sorites Indeterminacy.Philip M. Rosoff - 2019 - Journal of Medicine and Philosophy 44 (4):479-506.

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