Healthcare Rationing Term Paper

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Ethical Analysis of Healthcare Rationing

The topic of health care rationing has been the subject of debate in the U.S. The last few years as government expenditures on health care have far exceeded budgeted levels. Central to the concern is the ethical issue over whether it is better if fewer Americans profit with a greater amount of health resource allocation or if the majority benefit to a lesser degree for an equity in health care benefits. In the essay, "We've Got To Ration Health Care," (author unknown) the position is taken that America would fare better to follow the course of health care action seen in other western countries, where it is considered better to ration medical procedures to the extent that a system provides "the highest possible level of basic health care that can be delivered to all the people." With the growing concern over health care rationing, and the discussion of developing explicit government policy to provide authority over resource allocation, the ethics of current practice in medical directives must be examined for its usefulness, privileges, and community benefit.

According to Raymond J. Devettere, university professor in the Department of Philosophy at Emmanuel College, the rights-based Utilitarian theory that supports the "happiness" of the greatest number of individuals, can be applied to the clinical ethics perspective of health care rationing. He takes an Aristotoleian position that the decision-maker should base his or her ethical values on patient well-being rather than established guidelines prepared by others external to the case. This involves incorporating the perspectives of all individuals involved: the patient, relatives, doctors, nurses, administrators, and attorneys.

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This more Utilitarian view, as opposed to the essayist's equity perspective, outlines a dichotomy of moral opinion, relevant to health care rationing. To properly evaluate the reasoning of each, an ethical analysis should be applied.

By comparing Devettere's ethical principles to the essay, the morality of the argument can be examined, with several vulnerabilities to the ethical justification in the essay exposed. First, Devettere makes the point that omissions are not as easy to justify as actions. The essayist's perspective focuses on "omitting" treatments through rationing. Also, the judgment of futility of treatment is not morally conclusive and thus should not be waged as a reasonable argument in the essay. For instance, the concept of opting not to throw good money after bad in the case of withholding medical treatment to a dying patient is lacking in ethical justification. At the crux of the essay is the argument that guidelines for providing medical care, as set forth by some body (i.e. governing), are necessary to support rationing, is opposed by Devettere's theory that beliefs are not necessarily rooted in ethics, and for one group to decide for another what medical benefits will be allowed contradicts the morality of the whole. However, as Devettere considers, a moral disagreement does not disavow the morality of the ideal. The essay attempts to convey an ethical reasoning, but lacks in necessary justification.

In addition to the ethical debate surrounding rationing, there exists a major conflict with the essay's argument. The essayist writes, "The miracles of medicine have outpaced the ability...to pay for them," discriminating against advancing….....

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