Ethical Complexity of Distribute Justice and Rationing
Medicine is a practice based on moral standards applied to clinical values and judgments, also known as medical ethics. Ethical values consists of beneficence, nonmaleficence, autonomy and justice. However, these ethical principles are affected when distributive justice and rationing of health care resources are implemented “…in a world in which need is boundless but resources are not…” (Scheunemann & White, 2011, p. 1630).
The historic Hippocratic Oath described the four main principles of medical practice and established a moral conduct for clinicians. Beneficence demands that health care providers develop and maintain skills and knowledge, consider individual circumstances of all patients, and strive for the patient’s benefit. Nonmaleficence requires that a procedure or treatment does not harm the patient involved or others
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Nevertheless, “Health care providers will never be given enough resources to satisfy all demands placed upon them by a community that is becoming increasingly informed and demanding” (Capp, Savage, & Clarke, 2001, p.40). In addition, due to the scarcity of resources, it has become debatable whether health care is a privilege or a human right (Bodenheimer, 2009). Therefore, limited resources make rationing unavoidable and ethically complex.
Rationing can be described as the limitation of potentially beneficial resources to a patient due to resource insufficiency. An example of rationing in medicine is the process for organ transplants. In actuality, rationing has become more ethically complex due wasteful spending of health care resources in the United States. It is hypothesized that control of resource wasting will improve rationing ethics (Brody, 2012). Although, rationing is a controversial concept, without it, other basic components of society would be