Clozapine Rationing in a State Mental Hospital: Reviewing a HEC's Case Consultation
McFarland, Bentson H.
HEC (HealthCare Ethics Committee) Forum. 1993 Sep; 5(5): 302-318.
Clozapine (Clozaril) is a new, powerful, costly anti-psychotic medicine, with a possible serious side affect (agranulocytosis) that entails weekly blood monitoring. In a three hundred bed state mental hospital that is alloted thirty clozapine slots (high costs effectively rationing this drug), a woman with schizophrenia responds minimally to this medication. Her attending physician wishes to withdraw the medicine and give it to another patient with schizophrenia on the ward who might have a better response. The woman's family threatens to make a public outcry. Both the attending physician and the family ask the HEC for a consult.
Biomedical Technologies; Blood; Case Studies; Chronically Ill; Clinical Ethics; Clinical Ethics Committees; Consultation; Decision Making; Dissent; Drugs; Economics; Ethical Review; Ethicists; Ethics; Ethics Committees; Family Members; Futility; Guidelines; Hospitals; Institutionalized Persons; Life; Medicine; Mental Institutions; Patient Advocacy; Patient Care; Patient Care Team; Physicians; Prognosis; Psychiatry; Psychoactive Drugs; Public Hospitals; Quality of Life; Resource Allocation; Review; Risks and Benefits; Schizophrenia; Selection for Treatment; Standards; Treatment Outcome; Voluntary Admission; Withholding Treatment;
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