Results for 'priority setting in health care'

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  1.  65
    Priority Setting in Health Care: On the Relation Between Reasonable Choices on the Micro-Level and the Macro-Level.Kristine Bærøe - 2008 - Theoretical Medicine and Bioethics 29 (2):87-102.
    There has been much discussion about how to obtain legitimacy at macro-level priority setting in health care by use of fair procedures, but how should we consider priority setting by individual clinicians or health workers at the micro-level? Despite the fact that just health care totally hinges upon their decisions, surprisingly little attention seems being paid to the legitimacy of these decisions. This paper addresses the following question: what are the conditions (...)
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  2.  23
    Priority-Setting, Rationing and Cost-Effectiveness in the German Health Care System.Fuat S. Oduncu - 2013 - Medicine, Health Care and Philosophy 16 (3):327-339.
    Germany has just started a public debate on priority-setting, rationing and cost-effectiveness due to the cost explosion within the German health care system. To date, the costs for German health care run at 11,6 % of its Gross Domestic Product (GDP, 278,3 billion €) that represents a significant increase from the 5,9 % levels present in 1970. In response, the German Parliament has enacted several major and minor legal reforms over the last three decades (...)
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  3.  47
    Justice and Solidarity in Priority Setting in Health Care.Rogeer Hoedemaekers & Wim Dekkers - 2003 - Health Care Analysis 11 (4):325-343.
    During the last decade a “technical” approach has become increasingly influential in health care priority setting. The various country reports illustrate, however, that non-technical considerations cannot be avoided. As they often remain implicit in health care package decisions, this paper aims to make these normative judgements an explicit part of the procedure. More specifically, it aims to integrate different models of distributive justice as well as the principle of solidarity in four different phases of (...)
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  4.  23
    Priority Setting in Health Care: A Complementary Approach. [REVIEW]Rui Nunes & Guilhermina Rego - 2014 - Health Care Analysis 22 (3):292-303.
    Explicit forms of rationing have already been implemented in some countries, and many of these prioritization systems resort to Norman Daniels’ “accountability for reasonableness” methodology. However, a question still remains: is “accountability for reasonableness” not only legitimate but also fair? The objective of this paper is to try to adjust “accountability for reasonableness” to the World Health Organization’s holistic view of health and propose an evolutionary perspective in relation to the “normal” functioning standard proposed by Norman Daniels. To (...)
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  5.  8
    Priority Setting in Health Care: Trends and Models From Scandinavian Experiences. [REVIEW]Bjørn Hofmann - 2013 - Medicine, Health Care and Philosophy 16 (3):349-356.
    The Scandinavian welfare states have public health care systems which have universal coverage and traditionally low influence of private insurance and private provision. Due to raises in costs, elaborate public control of health care, and a significant technological development in health care, priority setting came on the public agenda comparatively early in the Scandinavian countries. The development of health care priority setting has been partly homogeneous and appears to (...)
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  6.  23
    A Strategy to Improve Priority Setting in Health Care Institutions.Doug Martin & Peter Singer - 2003 - Health Care Analysis 11 (1):59-68.
    Priority setting (also known as resource allocation or rationing) occurs at every level of every health system and is one of the most significant health care policy questions of the 21st century. Because it is so prevalent and context specific, improving priority setting in a health system entails improving it in the institutions that constitute the system. But, how should this be done? Normative approaches are necessary because they help identify key values (...)
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  7.  28
    Key Concepts in Health Care Priority Setting.Rogeer Hoedemaekers & Wim Dekkers - 2003 - Health Care Analysis 11 (4):309-323.
    In decisions about inclusion (or exclusion) of health care services in the benefit package, different interpretations of notions like health, health risk, disease, quality of life or necessary care often remain implicit. Yet they can lead to different benefit package decisions. After a brief discussion of these concepts in definitions of the goals of medicine, the various value-judgements implicit in interpretations of key notions in health care are analysed and conclusions are drawn with (...)
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  8.  7
    Why We Don’T Need “Unmet Needs”! On the Concepts of Unmet Need and Severity in Health-Care Priority Setting.Lars Sandman & Björn Hofmann - 2019 - Health Care Analysis 27 (1):26-44.
    In health care priority setting different criteria are used to reflect the relevant values that should guide decision-making. During recent years there has been a development of value frameworks implying the use of multiple criteria, a development that has not been accompanied by a structured conceptual and normative analysis of how different criteria relate to each other and to underlying normative considerations. Examples of such criteria are unmet need and severity. In this article these crucial criteria (...)
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  9.  19
    Priority Setting in Health Care: Lessons From the Experiences of Eight Countries.Lindsay M. Sabik & Reidar K. Lie - unknown
    All health care systems face problems of justice and efficiency related to setting priorities for allocating a limited pool of resources to a population. Because many of the central issues are the same in all systems, the United States and other countries can learn from the successes and failures of countries that have explicitly addressed the question of health care priorities. We review explicit priority setting efforts in Norway, Sweden, Israel, the Netherlands, Denmark, (...)
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  10.  14
    Making a Difference: A Qualitative Study on Care and Priority Setting in Health Care[REVIEW]Helge Skirbekk & Per Nortvedt - 2011 - Health Care Analysis 19 (1):77-88.
    The focus of the study is the conflict between care and concern for particular patients, versus considerations that take impartial considerations of justice to be central to moral deliberations. To examine these questions we have conducted qualitative interviews with health professionals in Norwegian hospitals. We found a value norm that implicitly seemed to overrule all others, the norm of ‘making a difference for the patients’. We will examine what such a statement implies, aiming to shed some light over (...)
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  11.  19
    Procedural Justice and Democratic Institutional Design in Health-Care Priority-Setting.Claudia Landwehr - 2013 - Contemporary Political Theory 12 (4):296-317.
    Health-care goods are goods with peculiar properties, and where they are scarce, societies face potentially explosive distributional conflicts. Animated public and academic debates on the necessity and possible justice of limit-setting in health care have taken place in the last decades and have recently taken a turn toward procedural rather than substantial criteria for justice. This article argues that the most influential account of procedural justice in health-care rationing, presented by Daniels and Sabin, (...)
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  12.  12
    The Relevance of Group Size in Health Care Priority Setting: A Reply to Juth.Lars Sandman & Erik Gustavsson - 2017 - Health Care Analysis 25 (1):21-33.
    How to handle orphan drugs for rare diseases is a pressing problem in current health-care. Due to the group size of patients affecting the cost of treatment, they risk being disadvantaged in relation to existing cost-effectiveness thresholds. In an article by Niklas Juth it has been argued that it is irrelevant to take indirectly operative factors like group size into account since such a compensation would risk discounting the use of cost, a relevant factor, altogether. In this article (...)
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  13.  6
    Health-Care Needs and Shared Decision-Making in Priority-Setting.Erik Gustavsson & Lars Sandman - 2015 - Medicine, Health Care and Philosophy 18 (1):13-22.
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  14.  16
    Distributive Justice and Priority Setting in Health Care.Yolonda Y. Wilson - 2018 - American Journal of Bioethics 18 (3):53-54.
  15.  3
    Allocation and Priority Setting in Health Care.Not Available Not Available - 1999 - Ethik in der Medizin 11 (2):119-120.
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  16.  2
    The Next Wave in Health Care Priority Setting.Annette Rid - 2018 - Hastings Center Report 48 (4):inside front cover-inside front.
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  17. Priority Setting at the Macro Level. Health Care in Relation to Other Fields of Social Policy.Volker H. Schmidt - 2010 - Ethik in der Medizin 22 (3):275-288.
     
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  18.  6
    Priority Setting From the Lens of Justice in Existing Health Care Industry of Pakistan.Faisal Nadeem - 2017 - Journal of Clinical Research and Bioethics 9 (1).
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  19.  89
    Universal Health Coverage, Priority Setting and the Human Right to Health.Benedict Rumbold, Octavio Ferraz, Sarah Hawkes, Rachel Baker, Carleigh Crubiner, Peter Littlejohns, Ole Frithjof Norheim, Thomas Pegram, Annette Rid, Sridhar Venkatapuram, Alex Voorhoeve, Albert Weale, James Wilson, Alicia Ely Yamin & Daniel Wang - 2017 - The Lancet 390 (10095):712-14.
    As health policy-makers around the world seek to make progress towards universal health coverage, they must navigate between two important ethical imperatives: to set national spending priorities fairly and efficiently; and to safeguard the right to health. These imperatives can conflict, leading some to conclude that rights-based approaches present a disruptive influence on health policy, hindering states’ efforts to set priorities fairly and efficiently. Here, we challenge this perception. We argue first that these points of tension (...)
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  20.  7
    The Role of Research in Setting Priorities for Health Care.Kathleen N. Lohr - 1996 - Journal of Evaluation in Clinical Practice 2 (1):79-82.
  21.  66
    Palliative Care, Public Health and Justice: Setting Priorities in Resource Poor Countries.Craig Blinderman - 2009 - Developing World Bioethics 9 (3):105-110.
    Many countries have not considered palliative care a public health problem. With limited resources, disease-oriented therapies and prevention measures take priority. In this paper, I intend to describe the moral framework for considering palliative care as a public health priority in resource-poor countries. A distributive theory of justice for health care should consider integrative palliative care as morally required as it contributes to improving normal functioning and preserving opportunities for the individual. (...)
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  22.  22
    An Ethical Analysis of International Health Priority-Setting.Nuala Kenny & Christine Joffres - 2008 - Health Care Analysis 16 (2):145-160.
    Health care systems throughout the developed world face ‘crises’ of quality, financing and sustainability. These pressures have led governments to look for more efficient and equitable ways to allocate public resources. Prioritisation of health care services for public funding has been one of the strategies used by decision makers to reconcile growing health care demands with limited resources. Priority setting at the macro level has yet to demonstrate real successes. This paper describes (...)
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  23.  19
    Decisions on Inclusion in the Swedish Basic Health Care Package—Roles of Cost-Effectiveness and Need.Lars Bernfort - 2003 - Health Care Analysis 11 (4):301-308.
    Background: Inclusion or not of a treatment strategy in the publicly financed health care is really a matter of prioritisation. In Sweden priority setting decisions are governed by law in which it is stated that decisions should be guided by firstly the principle of need and secondly the principle of cost-effectiveness.
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  24.  13
    The Significance of the Goal of Health Care for the Setting of Priorities.Per-Erik Liss - 2003 - Health Care Analysis 11 (2):161-169.
    The purpose of the article is to argue for the significance of a clarified goal of health care for the setting of priorities. Three arguments are explored. First, assessment of needs becomes necessary in so far as the principle of need should guide the priority-setting. The concept of health care need includes a goal component. This component should for rational reasons be identical with the goal of health care. Second, in order (...)
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  25.  44
    Ethical Theories and Values in Priority Setting: A Case Study of the Iranian Health System.A. Khayatzadeh-Mahani, M. Fotaki & G. Harvey - 2013 - Public Health Ethics 6 (1):60-72.
    Priority setting in health care means making distributional decisions, which inherently involves limiting access to some health services. Public health ethics involves many ethical principles like efficiency, equity and individual choice, which are frequently appealed to but rarely analysed. How these concepts are understood and applied impacts on healthcare planning and delivery policies. This article discusses findings of a research study undertaken in the context of the Iranian health system in which two main (...)
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  26.  10
    Crisis Management and Public Health: Ethical Principles for Priority Setting at a Regional Level in Sweden.Anders Nordgren - 2015 - Public Health Ethics 8 (1):72-84.
    In this article I analyse and discuss guidelines for priority setting in crisis management at a regional level in Sweden. The guidelines concern three types of crises: pandemics, large losses of electric power and interruptions in water supply. Pandemics are typical public health issues. Large losses of electric power and interruptions in water supply are in themselves not, but may have serious public health consequences. These guidelines are compared with guidelines for priority setting in (...)
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  27.  9
    Public Reasoning and Health-Care Priority Setting: The Case of NICE.Benedict Rumbold, Albert Weale, Annette Rid, James Wilson & Peter Littlejohns - 2017 - Kennedy Institute of Ethics Journal 27 (1):107-134.
    Health systems that provide for universal patient access through a scheme of prepayments—whether through taxes, social insurance, or a combination of the two—need to make decisions on the scope of coverage that they secure. Such decisions are inherently controversial, implying, as they do, that some patients will receive less than comprehensive health care, or less than complete protection from the financial consequences of ill-heath, even when there is a clinically effective therapy to which they might have access.Controversial (...)
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  28.  53
    Tensions in Setting Health Care Priorities for South Africa's Children.W. A. Landman & L. D. Henley - 1998 - Journal of Medical Ethics 24 (4):268-273.
    The new South African constitution commits the government to guarantee "basic health services" for every child under 18. Primary health care for pregnant women and children under six and elements of essential primary health care have received priority. At present, there is little analysis of the moral considerations involved in making choices about more advanced or costly health care which may, arguably, also be "basic". This paper illustrates some of the tensions in (...)
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  29.  25
    The Challenge of Measuring Community Values in Ways Appropriate for Setting Health Care Priorities.Peter A. Ubel - 1999 - Kennedy Institute of Ethics Journal 9 (3):263-284.
    : The move from a notion that community values ought to play a role in health care decision making to the creation of health care policies that in some way reflect such values is a challenging one. No single method will adequately measure community values in a way appropriate for setting health care priorities. Consequently, multiple methods to measure community values should be employed, thereby allowing the strengths and weaknesses of the various methods (...)
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  30. Priority Setting, Cost-Effectiveness, and the Affordable Care Act.Govind Persad - 2015 - American Journal of Law and Medicine 41 (1):119-166.
    The Affordable Care Act (ACA) may be the most important health law statute in American history, yet much of the most prominent legal scholarship examining it has focused on the merits of the court challenges it has faced rather than delving into the details of its priority-setting provisions. In addition to providing an overview of the ACA’s provisions concerning priority setting and their developing interpretations, this Article attempts to defend three substantive propositions. First, I (...)
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  31.  29
    Who Should Be Involved in Health Care Decision Making? A Qualitative Study.John McKie, Bradley Shrimpton, Rosalind Hurworth, Catherine Bell & Jeff Richardson - 2008 - Health Care Analysis 16 (2):114-126.
    Most countries appear to believe that their health system is in a state of semi-crisis with expenditures rising rapidly, with the benefits of many services unknown and with pressure from the public to ensure access to a comprehensive range of services. But whose values should inform decision-making in the health area, and should the influence of different groups vary with the level of decision-making? These questions were put to 54 members of the public and health professionals in (...)
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  32.  56
    Principles Versus Procedures in Making Health Care Coverage Decisions: Addressing Inevitable Conflicts.Lindsay M. Sabik & Reidar K. Lie - 2008 - Theoretical Medicine and Bioethics 29 (2):73-85.
    It has been suggested that focusing on procedures when setting priorities for health care avoids the conflicts that arise when attempting to agree on principles. A prominent example of this approach is “accountability for reasonableness.” We will argue that the same problem arises with procedural accounts; reasonable people will disagree about central elements in the process. We consider the procedural condition of appeal process and three examples of conflicts over coverage decisions: a patients’ rights law in Norway, (...)
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  33.  6
    Remote Monitoring or Close Encounters? Ethical Considerations in Priority Setting Regarding Telecare.Anders Nordgren - 2012 - Health Care Analysis (4):1-15.
    The proportion of elderly in society is growing rapidly, leading to increasing health care costs. New remote monitoring technologies are expected to lower these costs by reducing the number of close encounters with health care professionals, for example the number of visits to health care centres. In this paper, I discuss issues of priority setting raised by this expectation. As a starting-point, I analyse the recent debate on principles for priority (...) in Sweden. The Swedish debate illustrates that developing an approach to priority setting is an ongoing process. On the basis of this analysis, I conclude that several different ethical principles, and specifications of these principles, can be appealed to for giving priority—over close encounters—to a large-scale introduction of remote monitoring technologies in health care services to elderly people, but also that many specifications can be appealed to against giving such priority. I propose that given the different views on principles, it is necessary to develop fair procedures of deliberation on these principles and their application, in particular in order to reach agreement on exactly how much resources should be allocated to remote monitoring and how much to close encounters. I also present a few points to consider in a large-scale introduction of remote monitoring. (shrink)
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  34.  7
    Rhetoric Evidence and Policymaking : A Case Study of Priority Setting in Primary Care.Jill Russell & Trisha Greenhalgh - 2011 - In Philip Dawid, William Twining & Mimi Vasilaki (eds.), Evidence, Inference and Enquiry. Oup/British Academy. pp. 267.
    This chapter describes a study undertaken as part of the UCL Evidence programme to explore how policymakers talk about and reason with evidence. Specifically, researchers were interested in the micro-processes of deliberation and meaning-making practices of a group of people charged with prioritising health care in an NHS Primary Care Trust in the UK. The chapter describes how the research study brought together ideas from rhetorical theory and methods of discourse analysis to develop an innovative approach to (...)
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  35.  36
    Ethics of Resource Allocation: Instruments for Rational Decision Making in Support of a Sustainable Health Care.Claudia Wild - 2005 - Poiesis and Praxis 3 (4):296-309.
    In all western countries health care budgets are under considerable constraint and therefore a reflection process has started on how to gain the most health benefit for the population within limited resource boundaries. The field of ethics of resource allocation has evolved only recently in order to bring some objectivity and rationality in the discussion. In this article it is argued that priority setting is the prerequisite of ethical resource allocation and that for purposes of (...)
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  36.  10
    Book Review: Reasonable Rationing: International Experience of Priority Setting in Health.James E. Veney - 2004 - Inquiry: The Journal of Health Care Organization, Provision, and Financing 41 (1):108-109.
  37.  12
    Mind the Gap! Three Approaches to Scarcity in Health Care.Yvonne Denier - 2008 - Medicine, Health Care and Philosophy 11 (1):73-87.
    This paper addresses two ways in which scarcity in health care turns up and three ways in which this dual condition of scarcity can be approached. The first approach is the economic approach, which focuses on the causes of cost-increase in health care and on developing various mechanisms of rationing and priority-setting in health care. The second approach is the justice approach, which interprets scarcity as one of the Humean ‹Circumstances of Justice.’ (...)
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  38.  17
    Resource Allocation in Health Care: Health Economics and Beyond.Craig Mitton & Cam Donaldson - 2003 - Health Care Analysis 11 (3):245-257.
    As resources in health care are scarce, managers and clinicians must make difficult choices about what to fund and what not to fund. At the level of a regional health authority, limited approaches to aid decision makers in shifting resources across major service portfolios exist. A participatory action research project was conducted in the Calgary Health Region. Through five phases of action, including observation of senior management meetings, as well as two sets of one-on-one interviews and (...)
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  39.  11
    Successful Priority Setting in Low and Middle Income Countries: A Framework for Evaluation. [REVIEW]Lydia Kapiriri & Douglas K. Martin - 2010 - Health Care Analysis 18 (2):129-147.
    Priority setting remains a big challenge for health managers and planners, yet there is paucity of literature on evaluating priority setting. The purpose of this paper is to present a framework for evaluating priority setting in low and middle income countries. We conducted a qualitative study involving a review of literature and Delphi interviews with respondents knowledgeable of priority setting in low and middle income countries. Respondents were asked to identify the (...)
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  40.  4
    Incorporating Ethics in Priority Setting: A Case Study of a Regional Health Board in Canada.Michael Yeo, John R. Williams & Wayne Hooper - 1999 - Health Care Analysis 7 (2):177-194.
  41.  15
    Priorities in the Israeli Health Care System.Frida Simonstein - 2013 - Medicine, Health Care and Philosophy 16 (3):341-347.
    The Israeli health care system is looked upon by some people as one of the most advanced health care systems in the world in terms of access, quality, costs and coverage. The Israel health care system has four key components: (1) universal coverage; (2) ‘cradle to grave’ coverage; (3) coverage of both basic services and catastrophic care; and (4) coverage of medications. Patients pay a (relatively) small copayment to see specialists and to purchase (...)
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  42.  11
    Book Review: Managing Scarcity—Priority Setting and Rationing in the National Health Service. R. Klein, P. Day and S. Redmayre, 1996, Open University Press, 189 Pages, £13.99, ISBN 0335 19446X. [REVIEW]Jenny Donovan & Joanna Coast - 1997 - Health Care Analysis 5 (2):173-174.
  43.  7
    Conceptualizations of Fairness and Legitimacy in the Context of Ethiopian Health Priority Setting: Reflections on the Applicability of Accountability for Reasonableness.Kadia Petricca & Asfaw Bekele - 2018 - Developing World Bioethics 18 (4):357-364.
    A critical element in building stronger health systems involves strengthening good governance to build capacity for transparent and fair health planning and priority setting. Over the past 20 years, the ethical framework Accountability for Reasonableness has been a prominent conceptual guide in strengthening fair and legitimate processes of health decision-making. While many of the principles embedded within the framework are congruent with Western conceptualizations of what constitutes procedural fairness, there is a paucity in the literature (...)
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  44.  15
    Legitimate Policymaking: The Importance of Including Health-Care Workers in Limit-Setting Decisions in Health Care.Ann-Charlotte Nedlund & Kristine Bærøe - 2014 - Public Health Ethics 7 (2):123-133.
    The concept of legitimacy is often used and emphasized in the context of setting limits in health care, but rarely described is what is actually meant by its use. Moreover, it is seldom explicitly stated how health-care workers can contribute to the matter, nor what weight should be apportioned to their viewpoints. Instead the discussion has focused on whether they should take on the role of the patients’ advocate or that of gatekeeper to the society’s (...)
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  45.  3
    Constructing Citizen Engagement in Health Research PrioritySetting to Attend to Dynamics of Power and Difference.Bridget Pratt - forthcoming - Developing World Bioethics.
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  46.  30
    Towards Cost-Value Analysis in Health Care?Erik Nord - 1999 - Health Care Analysis 7 (2):167-175.
    By describing societal value judgements in health care in numerical terms one may in theory increase the precision of guidelines for priority setting and allow decision makers to judge more accurately the degree to which different health care programs provide societal value for money. However, valuing health programs in terms of QALYs disregards salient societal concerns for fairness in resource allocation. A different kind of numerical valuation of medical interventions, that incorporates concerns for (...)
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  47.  25
    Ethical Issues of Cost Effectiveness Analysis and Guideline Setting in Mental Health Care.R. Berghmans - 2004 - Journal of Medical Ethics 30 (2):146-150.
    This article discusses ethical issues which are raised as a result of the introduction of economic evidence in mental health care in order to rationalise clinical practice. Cost effectiveness studies and guidelines based on such studies are often seen as impartial, neutral instruments which try to reduce the influence of non-scientific factors. However, such rationalising instruments often hide normative assumptions about the goals of treatment, the selection of treatments, the role of the patient, and the just distribution of (...)
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  48.  26
    The Philosopher in the Health Care Setting: Objections and Replies. [REVIEW]Christopher D. Melley - 1992 - HEC Forum 4 (4):237-254.
    This article presents a serles of objections against having philosophers in the health care setting and rebuttals to these objections. These objections occur often enough to deal with them as characteristic criticisms. The rebuttals outline and advocate the positive — yet limited — function of the philosopher's presence in health care.
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  49.  18
    A Strategy to Improve Priority Setting in Developing Countries.Lydia Kapiriri & Douglas K. Martin - 2007 - Health Care Analysis 15 (3):159-167.
    Because the demand for health services outstrips the available resources, priority setting is one of the most difficult issues faced by health policy makers, particularly those in developing countries. Priority setting in developing countries is fraught with uncertainty due to lack of credible information, weak priority setting institutions, and unclear priority setting processes. Efforts to improve priority setting in these contexts have focused on providing information and tools. In (...)
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  50. Balancing Small Against Large Burdens.Alex Voorhoeve - 2018 - Behavioural Public Policy 2 (1):125-142.
    Common principles for resource allocation in health care can prioritize the alleviation of small health burdens over lifesaving treatment. I argue that there is some evidence that these principles are at odds with a sizable share of public opinion, which holds that saving a life should take priority over any number of cures for minor ailments. I propose two possible explanations for this opinion, one debunking and one vindicatory. I also outline how well-designed surveys and moral (...)
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