The “R” Word: Ethical Allocation of Medicine’s Resources
Fears about denial of needed medical care have consigned the “R” word to the unmentionable list. Yet unsustainable levels of expenditure for health care in the U.S. have forced us to consider, not whether we make resource allocation decisions, but how we make them justly and compassionately. And if we make them through a transparent, democratic process, how do we manage those single, bedside cases in which a loved one is ineligible to receive a needed treatment? This month’s contributors shed light on that question by struggling with it rigorously and honestly.
In cost-effectiveness research, the cost of a medical intervention is reported as a dollar amount per quality-adjusted life year gained—the quality of health and the length of time over which the health state exists.
If I am unwilling to pay more taxes so an 85-year-old stranger can have a left-ventricular assist device, then I am morally obligated to say the same holds true for a future version of me in those same circumstances.