The Asbury Draft Policy on Ethical Use of Resources
Thomasma, David C.
BMJ (British Medical Journal). 1996 Jun 15; 312(7045): 1528-1533.
Many doctors find themselves torn between two contradictory principles: to do the best for the individual patient and to be responsible for an overall budget that is insufficient for the best care for each individual patient. Little guidance is available for doctors on how to resolve this conflict. Crisp et al present a draft document that one fundholding general practice has developed to clarify the ethical basis for rationing decisions. We invited three interested professionals to comment on the draft. The general practice partners invited two medical ethicists [Roger Crisp and Tony Hope] (RC and TH) to meet them to develop the document. The partners met RC and TH for one and a half hours on eight occasions over one year and met without them on eight further occasions. The entire general practice also had an all day session to discuss in detail an advanced version of the draft. The developmental process was of great value to the partnership and has led to appreciable change in individuals' views. The draft policy presented here is intended to start the ball rolling, so that proper guidelines will be developed at whatever level in the NHS is most appropriate. Comments and feedback are welcomed.
Age Factors; Alternatives; Autonomy; Chronically Ill; Decision Making; Disclosure; Doctors; Economics; Ethicists; Family Practice; Guidelines; General Practice; Health; Health Care; Illness; Justice; Life; Patient Advocacy; Patients; Physicians; Practice Guidelines; Quality Adjusted Life Years; Resource Allocation; Selection for Treatment; Terminal Care; Values;
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Hope, Tony; Sprigings, David; Crisp, Roger (1993-02-06)The decision that a particular intervention is not clinically indicated may conceal two quite different ethical assumptions. The first assumption is that the intervention is not of overall benefit to this patient. The ...