RESOURCE ALLOCATION EQUITABLE DISTRIBUTION AND JUSTICE STANDARDS FOR

RESOURCE ALLOCATION EQUITABLE DISTRIBUTION AND JUSTICE

STANDARDS FOR ALLOCATION • ARBITRARY – AGE – PERSONAL WEALTH – RESOURCE LOTTERY – SOCIAL LOTTERY • NATURAL – FINITUDE – BENEFIT TO PATIENT – PATIENT SELF-RESTRAINT IN DECISION MAKING

LIMITATIONS ON RESOURCES • FUTILE TREATMENT • COSTWORTHY TREATMENT – SUFFICIENT BENEFITS FOR BURDENS • SOURCE OF TREATMENT • OTHER SOCIETAL PRIORITIES • WEIGHING ALTERNATIVES

PUBLIC POLICY DECISIONS • DECISIONS ABOUT CATEGORIES OF PATIENTS • DRIVEN BY SOCIAL UTILITIES • CAUTION ABOUT SPECIAL INTEREST GROUPS

PATIENT SELF-RESTRAINT • PATIENT VALUES • EXERCISE OF AUTONOMY • REFUSAL OF TREATMENT – CHOICES AMONG ALTERNATIVES • IMPORTANCE OF INFORMED CONSENT

DETERMINATION OF BENEFITS FOR PATIENTS • CLEARLY BENEFICIAL • NO BENEFIT (FUTILE) • BURDENS OUTWEIGH BENEFITS (INADVISABLE) • COSTWORTHINESS • IMPORTANCE OF REALISTIC ASSESSMENT OF BENEFITS

OREGON’S CRITERIA FOR ALLOCATION • INCREASE LONGEVITY SIGNIFICANTLY • IMPROVE QUALITY OF LIFE – RESTORE CONSCIOUSNESS – ALLEVIATE PAIN – ALLOW FOR INDEPENDENCE OF FUNCTION – IMPROVE “CARABILITY” • EFFICIENCY (UTILITARIAN CONSIDERATIONS) • EQUITY – TREAT SIMILAR CASES SIMILARLY – UNIVERSAL ACCESS TO A BASIC SET OF CARE