The challenge of resource allocation: wise decisions require organizations to ask difficult questions.

Br. Maddix, formerly vice president, organizational advancement, Caritas Health Group, Edmonton, Alberta, is now vice president, mission, ethics, and spirituality, Providence Health Care, Vancouver, British Columbia. He is the author, with Ian C Soles, of Journey to Wholeness: Healing Body, Soul and Mind (Novalis Publishing, Montreal, 2003). The just and fair allocation of resources has always required integrity, trust in Providence, and a willingness to grapple with the unknown. Today, health care providers struggle to make good decisions in the face of high public expectations concerning service; a shrinking public purse; and mounting costs for labor, pharmaceuticals, and technology. Caritas Health Group, Edmonton, Alberta, recently became determined to make its resourceallocation process as transparent as possible, thereby reinforcing the justice and fairness of the decisions involved. Before describing this initiative, however, I need to say something about the larger problem.