Rationing at the bedside: Immoral or unavoidable?

Clinical Ethics 11 (4):112-121 (2016)

Abstract
Although most theorists of healthcare rationing argue that rationing, including rationing that takes place in the physician–patient relationship is unavoidable, some health professionals strongly disagree. In a recent essay, Vegard Bruun Wyller argues that bedside rationing is immoral and thoroughly at odds with a sound view of the physician–patient relationship. We take Wyller to be an articulate exponent of the reluctance to participate in rationing found among some clinicians. Our essay attempts to refute the five crucial premises of his argument yet build on his genuine insights. In our analysis, Wyller’s critique of bedside rationing is instructive both for harbouring some very common misconceptions that must be exposed and refuted, but also for offering important words of caution. In particular, bedside rationing must be performed in ways that do not harm the physician–patient relationship. Read irenically, Wyller’s critique is a reminder of what must not be lost in our painful endeavour to update the ethics of medicine to encompass the unavoidability of rationing.
Keywords Professional ethics   clinical ethics   resource allocation   priority setting
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DOI 10.1177/1477750916657664
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References found in this work BETA

World Poverty and Human Rights.Thomas Pogge - 2002 - Ethics and International Affairs 19 (1):1-7.
Ethical Consistency.B. A. O. Williams & W. F. Atkinson - 1965 - Aristotelian Society Supplementary Volume 39 (1):103-138.
Why It's Not Time for Health Care Rationing.Peter A. Ubel - 2015 - Hastings Center Report 45 (2):15-19.
A Framework for Rationing by Clinical Judgment.Samia A. Hurst & Marion Danis - 2007 - Kennedy Institute of Ethics Journal 17 (3):247-266.

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