UNIGE document Professional Article
previous document  unige:84955  next document
add to browser collection

A framework for rationing by clinical judgment

Danis, Marion
Published in Kennedy Institute of Ethics Journal. 2007, vol. 17, no. 3, p. 247-266
Abstract Although rationing by clinical judgment is controversial, its acceptability partly depends on how it is practiced. In this paper, rationing by clinical judgment is defined in three different circumstances that represent increasingly wider circles of resource pools in which the rationing decision takes place: triage during acute shortage, comparison to other potential patients in a context of limited but not immediately strained resources, and determination of whether expected benefit of an intervention is deemed sufficient to warrant its cost by reference to published population based thresholds. Notions of procedural justice are applied along with an analytical framework of six minimal requisites in order to facilitate fair bedside rationing: (1) a closed system that offers reciprocity, (2) attention to general concerns of justice, (3) respect for individual variations, (4) application of a consistent process, (5) explicitness, and (6) review of decisions. The process could be monitored for its applicability and appropriateness.
Keywords Blood Transfusion/ethicsClinical CompetenceCost-Benefit AnalysisCritical Care/ethicsDecision Making/ethicsEthics, ClinicalEthics, MedicalHealth Care Rationing/ethics/methodsHumansInfluenza Vaccines/administration & dosageIntensive Care Units/ethics/manpower/supply & distributionPersonal AutonomySocial JusticeTriage/ethicsVaccination/ethics
PMID: 18210983
Full text
Article (Published version) (146 Kb) - document accessible for UNIGE members only Limited access to UNIGE
Other version: https://muse.jhu.edu/article/224817/pdf
Research group Ethique biomédicale (783)
(ISO format)
HURST, Samia, DANIS, Marion. A framework for rationing by clinical judgment. In: Kennedy Institute of Ethics Journal, 2007, vol. 17, n° 3, p. 247-266. doi: 10.1353/ken.2007.0021 https://archive-ouverte.unige.ch/unige:84955

280 hits

0 download


Deposited on : 2016-07-04

Export document
Format :
Citation style :