0
Medical Ethics |

The Ethics and Reality of Rationing in MedicineThe Ethics and Reality of Rationing in Medicine

Leslie P. Scheunemann, MD, MPH; Douglas B. White, MD; for the Task Force on Values, Ethics, and Rationing in Critical Care (VERICC)
Author and Funding Information

From the Division of Geriatric Medicine and Center for Aging and Health (Dr Scheunemann), University of North Carolina Hospitals, Chapel Hill, NC; the Program on Ethics and Decision Making in Critical Illness (Dr White), Department of Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA; and the Center for Bioethics and Health Law (Dr White), University of Pittsburgh, Pittsburgh, PA.

Correspondence to: Douglas B. White, MD, Program on Ethics and Decision Making in Critical Illness, Department of Critical Care Medicine, University of Pittsburgh Medical Center, 3550 Terrace St, Scaife Hall, Room 608, HPU010604, Pittsburgh, PA 15261; e-mail: whitedb@upmc.edu

Editor’s note: This review addresses the 15th topic in the core curriculum of the ongoing “Medical Ethics” series. To view all articles included in the “Medical Ethics” series, visit http://chestjournal.chestpubs.org/cgi/collection/medethics.

Constantine A. Manthous, MD, FCCP, Section Editor, Medical Ethics

Funding/Support: Dr Scheunemann was supported by the Hartford Center of Excellence in Geriatric Medicine and Training. Dr White was supported by a Greenwall Foundation Faculty Scholars award and a Paul Beeson Award in Aging Research from the National Institute on Aging.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


Editor’s note: This review addresses the 15th topic in the core curriculum of the ongoing “Medical Ethics” series. To view all articles included in the “Medical Ethics” series, visit http://chestjournal.chestpubs.org/cgi/collection/medethics.

Constantine A. Manthous, MD, FCCP, Section Editor, Medical Ethics

Editor’s note: This review addresses the 15th topic in the core curriculum of the ongoing “Medical Ethics” series. To view all articles included in the “Medical Ethics” series, visit http://chestjournal.chestpubs.org/cgi/collection/medethics.

Constantine A. Manthous, MD, FCCP, Section Editor, Medical Ethics

Funding/Support: Dr Scheunemann was supported by the Hartford Center of Excellence in Geriatric Medicine and Training. Dr White was supported by a Greenwall Foundation Faculty Scholars award and a Paul Beeson Award in Aging Research from the National Institute on Aging.

Funding/Support: Dr Scheunemann was supported by the Hartford Center of Excellence in Geriatric Medicine and Training. Dr White was supported by a Greenwall Foundation Faculty Scholars award and a Paul Beeson Award in Aging Research from the National Institute on Aging.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


Chest. 2011;140(6):1625-1632. doi:10.1378/chest.11-0622
Text Size: A A A
Published online

Rationing is the allocation of scarce resources, which in health care necessarily entails withholding potentially beneficial treatments from some individuals. Rationing is unavoidable because need is limitless and resources are not. How rationing occurs is important because it not only affects individual lives but also expresses society’s most important values. This article discusses the following topics: (1) the inevitability of rationing of social goods, including medical care; (2) types of rationing; (3) ethical principles and procedures for fair allocation; and (4) whether rationing ICU care to those near the end of life would result in substantial cost savings.


Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543