The Ethics of Health Care Rationing
El racionament és inevitable, vivim en un món de recursos finits. Però els nostres ulls i el nostre cervell fan com si no se n'adonessin. Passem de llarg del tema com a societat, mentre que com individus hi topem de sobte quan ens trobem a una llista d'espera o quan hem de pagar per una prestació.
En la reedició d'aquest llibre es tracten aquests temes:
- What sort of distributive principles should we rely on when thinking about health care rationing?
- What is the relation between ethics and cost-effectiveness in health care?
- How should we think about controversies surrounding discrimination over disability and age?
- How should we approach controversies surrounding rationing and the price of pharmaceutical drugs and medical therapies?Should patients be held responsible for their health?
- Why does the debate on responsibility for health lead to issues about socioeconomic status and social inequality?
Rationing, in its broadest sense, is the controlled allocation of some scarce resource or good. It implies that limits are placed on the good’s availability. People who need or want the rationed good are restricted to getting it in a certain quantity or size or at a certain time. They are not free to use or consume it in the way they want.
I l'objectiu del llibre:
Our aim in this book is to show you that health care rationing not only can be ethical, but also it must be. Our case is very simple. We shall argue that the rationing of health care resources is inevitable. It takes place in all health care systems – public or private, rich or poor. It is not only inevitable, it is actually ubiquitous as well. So you might consider it a necessary evil. But then it is crucial that it is done as ethically as possible to reduce its evil effect. Hence, you should care about the ethics of rationing health care. It is not an oxymoron.
Two relevant, basic moral ideas are the maximization of the benefits from the use of health care resources and the fairness of the distribution of those benefits.
En definitiva, explica clarament moltes coses que els decisors no volen sentir, o que fan veure que no ho senten i així passen de llarg del tema. La política sanitària propera fa temps que prefereix la discrecionalitat a la transparència del cost-efectivitat. No és cap casualitat que no hi hagi cap CATNICE, una experiència catalana semblant al NICE.
