There is unquestionably a problem with how medical resources are distributed in modern society. As a result, healthcare is distributed inequitably in many nations worldwide. The article by Kluge (2007) identifies three different interpretations of the nature of medicine, demonstrates how each one necessitates a different approach to resource allocation and makes the argument that the allocation issue will remain unsolvable unless a suitable model of medicine is developed that acknowledges the legitimate points contained in each of the three approaches.
The Hippocratic Model
The Hippocratic medicine model focuses on the physician-patient encounter and establishes a fiduciary relationship between them. This model states that a physician must act in the patient’s best interest and cannot consider social cost, the impact on other members of society, or the healthcare budget when allocating resources. Balancing rights is not a legitimate concern for the physician, and cost-benefit and cost-effectiveness considerations must be abandoned. The issue for the physician is not how to allocate resources fairly but how to acquire the resources needed to fulfill the patient's fiduciary duty of care. Ultimately, the resolution to resource scarcity will have to occur in terms of professional power and persuasiveness rather than allocation ethics (Kluge, 2007).
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The physician-patient encounter is seen as a means of actualizing this social role, and physicians have delegated authority in healthcare delivery as society's agents. Allocation issues are addressed in terms of balancing competing for the proper claims and resolving them in a utilitarian approach that produces the greatest good for the most significant number. Cost-benefit and cost-effectiveness considerations are legitimate, and outcome measures focus on the social impact of interventions (Kluge,