Economics dictates that resources are scarce and human wants are limitless. This is also the case in healthcare where some of the resources are scarce and require rationing. According to Bognar & Hirose (2014), rationing is the allocation of resources that are scarce. In health care, rationing encompasses of withholding treatments that are potentially beneficial for particular persons on the basis of scarcity. Rationing is unavoidable because needs are limitless and resources are scarce. Therefore, the most contentious issue is whether rationing, particularly in healthcare, is ethical or not because rationing in itself and how it is done affects individual lives and also justify some of the important societal values.
I believe that rationing is ethically sound in healthcare because resources available for social goods such as healthcare are limited and have to be utilized in such a way that benefits most of the people in the society. Scheunemann & White, (2011) point out that social goods such as healthcare, defense, education, environmental protection, public health, and infrastructure obtain finance from a common pool. The resources existing to supply such social goods are scarce, yet the needs are limitless. As such, trying to meet all the healthcare demands will likely stretch the government capability to supply the basic elements of other social goods like education, public health, and defense. As such, rationing of the healthcare resources to some degree is requisite for the overall well-being of the society.
Because rationing is ethically justifiable, how it is done is very important. There are set rationing principles that determine who should receive care and who should not. Rationing should be done based on distributive justice to reduce conflicting differences (Scheunemann & White, 2011). First of all, rationing should be conducted in such a manner to maximize efficiency (utilitarianism). This implies that rationing decisions should produce the most good in the society with the least expenditure. Rationing in health care should also be conducted on the basis of equity (Egalitarianism). This principle proposes that healthcare professionals should provide equal opportunity to individuals to have the basic goods in life, for instance, the first-come, first-served strategy to allocate scarce resources.
Rationing can also be conducted based on To each to favor the worst off (Prioritarianism) principle where those who are considered worst off are given priority in situations where all cannot receive the particular resources (Scheunemann & White, 2011). For instance, the young should be allocated medical resources before the old because the young still have the chance to live through the different lifes stages. The rule of rescue where those facing death should be allocated scarce resources, no matter how small the chance of benefit or how expensive is the process can also be applied.
It is important to balance the trade-offs between the different principles to prioritize the scarce healthcare resources. As such, the process of rationing health care resources should be fair. For rationing to be fair, it should be supervised by a legal institution, the process should be transparent, the principles and information guiding decision making should be accepted by all as relevant, and procedures for revising and appealing decisions should be put in place (Bognar, & Hirose, 2014).
Rationing is ethically sound in healthcare because of the scarcity of resources and unlimited human wants. However, how it is rationed, the transparency of rationing and levels at which health care is rationed play a major role in creating a just and sustainable health care system. As such, ethical rationing in healthcare necessitates making rational choices based on fair procedures and guiding principles.
Bognar, G., & Hirose, I. (2014). The ethics of health care rationing: an introduction. Routledge.
Scheunemann, L. P., & White, D. B. (2011). The Ethics and Reality of Rationing in Medicine. Chest, 140(6), 16251632. http://doi.org/10.1378/chest.11-0622
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