all societies face the need to make judgments about what interventions (both public health and personal medical) to provide to their populations under reasonable resource constraints. their decisions should be informed by good evidence and arguments from health technology assessment (hta). but if hta restricts itself to evaluations of safety, efficacy, and cost-effectiveness, it risks being vie...

OBJECTIVE To describe priority setting for admissions in a hospital critical care unit and to evaluate it using the ethical framework of "accountability for reasonableness. DESIGN Qualitative case study and evaluation using the ethical framework of accountability for reasonableness. SETTING A medical/surgical intensive care unit in a large urban university-affiliated teaching hospital in To...

OBJECTIVES To describe and evaluate the priority-setting element of a hospital's strategic planning process. METHODS Qualitative case study and evaluation against the conditions of 'accountability for reasonableness' of a strategic planning process at a large urban university-affiliated hospital. RESULTS The hospital's strategic planning process met the conditions of 'accountability for rea...

OBJECTIVES The purpose of this study was to describe the process used to decide which patients are admitted to the intensive care unit (ICU) at a hospital with special focus on access for neurosurgery patients, and evaluate it using "accountability for reasonableness". METHODS Qualitative case study methodology was used. Data were collected from documents, interviews with key informants, and ...

BACKGROUND Priority setting is one of the most difficult issues facing hospitals because of funding restrictions and changing patient need. A deadly communicable disease outbreak, such as the Severe Acute Respiratory Syndrome (SARS) in Toronto in 2003, amplifies the difficulties of hospital priority setting. The purpose of this study is to describe and evaluate priority setting in a hospital in...

All societies face the need to make judgments about what interventions (both public health and personal medical) to provide to their populations under reasonable resource constraints. Their decisions should be informed by good evidence and arguments from health technology assessment (HTA). But if HTA restricts itself to evaluations of safety, efficacy, and cost-effectiveness, it risks being vie...

Accountable decision-makers are required to legitimize their priority setting decisions in health to members of society. In this perspective we stress the point that fair, legitimate processes should reflect efforts of authorities to treat all stakeholders as moral equals in terms of providing all people with well-justified, reasonable reasons to endorse the decisions. ...