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Hverjir eiga að bíta við útgarðana? : um forgangsröðun í heilbrigðiskerfinu

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Authors
Kristján Kristjánsson
Issue Date
1995-10-01

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Other Titles
Falling by the wayside? On priorities in the allocation of health-care resources
Citation
Læknablaðið 1995, 81(10):707-14, 716-8, 720-2, 724-6
Abstract
This essay serves a twofold purpose. The first is to offer a brief overview of recent discussions of what constitutes a just model of rationing in health care, i.e. how the problem of scarce health resources is to be correctly analysed and solved. Moreover, the relevance of general philosophical theories of justice to this specific problem is given some consideration. A whole gamut of already-suggested models is examined, with special emphasis on the weaknesses of each particular proposal. The second goal of the essay is to evoke serious doubts about the viability of some of the most prominent and popular models of just rationing; the main target being the ageism inherent in them. Another model is suggested and defended: a utilitarian one, which puts the whole issue of resource allocation in a wider perspective, taking into account, inter alia, the extent to which patients deserve the service they require.
Markmið þessarar ritgerðar er tvíþætt. Í fyrra lagi að veita yfirlit yfir þá umræðuhefð sem skapast hefur á Vesturlöndum varðandi réttláta forgangsröðun í heilbrigðisþjónustu, greiningu vandans og mögulegar lausnir hans. Hugað verður að tengingu við almennar heimspekikenningar um réttlæti; og í ljósi þess að allar lausnirnar eru neyðarbrauð, í heimi takmarkaðra gæða, verður fremur rýnt í galla þeirra en kosti. Síðara markmiðið er að vekja efasemdir um þær lausnir sem mest hefur kveðið að í umræðunni hingað til og gera, þó með ólíkum hætti sé, aldur sjúklings að einu helsta kennimarki við skipan í forgangsröð: því hærri aldur, þeim mun lakari röðun. Borið er í bætifláka fyrir annan kost, nytjakvarða, sem lítur á málið frá víðara sjónarhorni og tekur meðal annars til greina að hvaða leyti sjúklingurinn verðskuldar þá þjónustu sem skammta þarf.
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http://www.laeknabladid.is
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Icelandic Journal Articles (Peer Reviewed)

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