Fair Resource Allocation and Rationing at the Bedside

ISBN : 9780190882136

Marion Danis; Samia A. Hurst; Len Fleck; Reidun Forde; Anne Slowther
480 Pages
156 x 234 mm
Pub date
Jul 2018
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Priority setting and rationing contribute significantly to affordable and fair healthcare and clinicians play an indispensable role in these processes. This book offers practical strategies for clinicians to allocate resources fairly, to teach about it to students, and to discuss rationing more explicitly in the public arena and the doctor's office.


Marion Danis, Reidun Forde, Leonard M. Fleck, Samia A. Hurst, Anne Slowther
Part I. A European Survey of Bedside Rationing
Chapter 1. The Values at the Bedside Study: Bedside rationing by physicians
Samia A. Hurst, Anne Slowther, Reidun Forde, and Marion Danis
Chapter 2. The interaction of bedside rationing and the fairness of healthcare systems: Physicians' views
Samia A. Hurst, Reidun Forde, Anne Slowther, and Marion Danis
Part II The Societal Context
Chapter 3. The Swiss Context.
Samia A. Hurst
Chapter 4. The UK Context.
Anne Slowther
Chapter 5. The Norwegian Context.
Reidun Forde
Chapter 6. The Italian Context
Renzo Pegoraro and Alessandra Bernardi
Part III Analysis of Bedside Rationing
Chapter 7. How Do Economic Incentive Schemes Influence Rationing Decisions by Primary Care Physicians?
Tommy Allen, Matt Sutton, and Richard Cookson
Chapter 8. The legal context of bedside rationing.
Keith Syrett
Chapter 9. Bedside Rationing or Rational Planning: In Search of Perspective on Medical Benefit and Safety
Michael Barilan
Chapter 10. Just Caring: The Ethics Challenges of Bedside Rationing
Leonard M. Fleck
Chapter 11. Overdiagnosis and Overtreatment: Implications for Bedside Rationing
Howard Brody
Chapter 12. How can bedside rationing be justified despite coexisting inefficiency? The need for benchmarks of efficiency
Daniel Strech and Marion Danis
Chapter 13. The Collective Action Problem
Bob Goodin
Chapter 14. Statistical vs. Identifiable Lives: Why Not to Use the R Word.
Paul Menzel
Chapter 15. Give to The Doctor What is Due to The Doctor! Why 'Fair Rationing at The Bedside' is Impossible
Vegard Bruun Wyller
Part IV. Strategies for Promoting Fair Bedside Rationing
Chapter 16. Priority Setting in Hospital Care: Implementing National Legislation and Guidelines in a Hospital Trust
Odd Soreide, Stener Kvinnsland, and Torhild Heggestad
Chapter 17. Rationing by Clinical Judgment
Samia A. Hurst and Marion Danis
Chapter 18. Fairness and Transparency in Bedside Micro-allocation: Improving the Ethical Competence of Clinical Staff
Jan Schurmann, Barbara Meyer-Zehnder, Marcel Mertz, Heidi Albisser Schleger, Mathias Schlogl, Reto Kressig, Hans Pargger, and Stella Reiter-Theil
Chapter 19. Fair Resource Allocation in Clinical Care for Socially Disadvantaged Groups and Health Disparity Populations: Issues and Strategies
Irene Dankwa-Mullan, Paula Goodwin, and Matthew Wynia
Chapter 20. Bedside Rationing After Health Care Reform in the United States: The Emergence of Accountable Care Organizations
Steven D. Pearson
Chapter 21. Priority Setting Through Clinical Practice Guidelines: Lessons Learned
Ole Norheim
Chapter 22. Physicians as Bellwethers.
Susan Dorr Goold
Chapter 23. Moving Away from Silent Trepidation: Changing the Discussion of Rationing and Resource Allocation
Marion Danis, Greer Donley and Reidun Forde
Chapter 24. Priority Setting As a Clinical Skill: How Do We Educate Physicians?
Anne Slowther and Benjamin P Bennett

About the author: 

Marion Danis is Head of the Section on Ethics and Health Policy in the Department of Bioethics in the Clinical Center of the National Institutes of Health and Chief of the Bioethics Consultation Service at the Clinical Center. Her research focuses predominantly on improving the health of disadvantaged populations and on strategies for public engagement in priority setting. She is also serves as a general internist in a primary care clinic Montgomery County, Maryland.; Samia A. Hurst is professor of Bioethics and ethics consultant at Geneva University's medical school in Switzerland, chief editor of the Swiss bioethics journal Bioethica Forum, and a member of Switzerland's National Ethics Advisory Commission on Biomedical Ethics. Her research focuses on fairness in clinical practice, and the protection of vulnerable persons.; Leonard Fleck, Ph.D. is a Professor of Philosophy and Medical Ethics in the Center for Ethics and Humanities in the Life Sciences, College of Human Medicine, Michigan State University. His areas of research include social and political philosophy, theories of health care justice, health care rationing, democratic deliberation, ethical and policy issues related to genetics.; Reidun Forde is an MD and a previous Chair of the Council for Medical Ethics , Norwegian Medical Association. She was member of the second governmental commission on health priority making in Norway, and is also a member of the recently appointed third priority commission. She was also member of the first National Health Priority Council. Her research is on clinical ethics, end of life issues and resource allocation issues.; Anne Slowther is Associate Professor of Clinical Ethics at Warwick Medical School, UK, an ethics consultant at the University Hospital Coventry and Warwickshire NHS Trust, and a family physician. She is chair of the UK Clinical Ethics Network and a member of the Governing Body of the Institute of Medical Ethics. Her interests are in ethical decision making in clinical practice and evaluation of clinical ethics support.

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