Just Health Care Rationing: A Democratic Decisionmaking Approach

Just health care rationing: a democratic decisionmaking approach.

Michael S. was born in 1984 to unmarried teenage parents who were without health insurance. He was born with necrotic small bowel syndrome. Surgery at-birth determined that he would not be able to process food in the normal way. Hence, he would have to remain in an intensive care unit, fed via total parenteral nutrition (TPN). After six months the hospital administrator approached the attending...

Just Solidarity: the Key to Fair Health Care Rationing

I agree with Professor ter Meulen that there is no need to make a forced choice between “justice” and “solidarity” when it comes to determining what should count as fair access to needed health care. But he also asserts that solidarity is more fundamental than justice. That claim needs critical assessment. Ter Meulen recognizes that the concept of solidarity has been criticized for being excess...

Slim just left town: decisionmaking on an intensive care unit.

The title of this paper comes from an incident that occurred while I was participating in morning rounds on the pediatric and surgical intensive care unit of a large, midwest tertiary care center. The patient under discussion was an eight-week-old girl who had been born without kidneys, and who had been cared for on the unit for seven weeks. In the previous week, the baby's condition had gone s...

Health Care Rationing: A Critical Evaluation

Rationing health care in Canada.

Canada has been able to develop a fairly successful system of healthcare rationing by balancing the conflicting concerns of equal access and cost efficiency, federal funding and provincial control, and public sector management and private sector provision. Financial constraints limit the kinds of services included within the notion of equal access, however, forcing healthcare providers to make ...