Who should get the kidney machine?

This paper considers the problem that arises when the number of patients who need a resource exceeds the supply. An initial decision-making model is proposed that uses two essential criteria, medical prognosis and the priority of life-threatening situations. The model is then subjected to the critic...

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Bibliographic Details
Published in:Journal of medical ethics 1992-03, Vol.18 (1), p.12-17
Main Author: Langford, M J
Format: Article
Language:English
Subjects:
Algorithms
Bioethics
Care and treatment
Decision making
Decision Support Techniques
Emergencies
Ethical Analysis
Ethical Theory
Fuzziness
Gender discrimination
Health Care Rationing - standards
Hospital patients
Humans
Kidneys
Medical ethics
Mothers
Patient Advocacy - standards
Patient Selection
Prognosis
Random allocation
Rationing
Renal Dialysis - standards
Resource Allocation
Risk Assessment
Scarce resources
Social discrimination
Value of Life
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Summary:This paper considers the problem that arises when the number of patients who need a resource exceeds the supply. An initial decision-making model is proposed that uses two essential criteria, medical prognosis and the priority of life-threatening situations. The model is then subjected to the criticism that it is grotesque to ignore questions relating to the value of, for example, a productive mother over against an aged recluse, and to treat them as having equal rights to access. It is argued that this criticism need not be an expression of prejudice but may reflect a defendable view in which utilitarian considerations enter into the selection process provided that certain fundamental, or 'deontological' rights are observed for all. In the light of the discussion the model is modified in order to contain both a non-utilitarian feature that stresses the intrinsic importance of all persons, and a utilitarian feature that can allow one, in certain circumstances, to take consequences into account, especially those that follow from the 'irreplaceability' of some people.
ISSN:0306-6800
1473-4257
DOI:10.1136/jme.18.1.12