Health Care Rationing and the Badness of Death

Author(s):  
Tim Campbell

According to Jeff McMahan, health care professionals ought to save an individual, A, from dying as a young adult (e.g., at age 30) rather than save some other individual, B, from dying as a newborn, even if the latter intervention would give B twice as many years of full-quality life as the former intervention would give A. Call this claim Young Adults over Newborns. In this chapter, I argue that if we accept Young Adults over Newborns, then we must reject at least one of three other more plausible claims. This constitutes a strong reason to reject Young Adults over Newborns.

2018 ◽  
Vol 15 (1) ◽  
pp. 113-127
Author(s):  
Micaela Pinho ◽  
Pedro Veiga

AbstractThis paper tests the factorial structure of a questionnaire comprising seven health care rationing criteria (waiting time, ‘rule of rescue’, parenthood of minors, health maximization, youngest first, positive and negative version of social merit) and explores the adherence to them of 254 Portuguese health care professionals, when considered individually and when confronted with two-in-two combinations. Data were collected through a self-administered questionnaire where respondents faced hypothetical rationing dilemmas comprising one rationing criterion and dichotomous options pairs with two rationing criteria. Confirmatory factor analysis and multinomial logistic regressions were used to validate the structure of the questionnaire and the data. The findings suggest that: (i) the hepta-factorial structure of the questionnaire presented a good fit of the data; and (ii) support for rationing criterion depends on whether they are individually considered or confronted in dichotomous options pairs. When only one criterion distinguishes the patients, healthcare professionals support six criteria (by descending order): waiting time, rule of rescue, health maximization, penalization of patients’ risky behaviors, youngest first and being parent of a young child. When two criteria were confronted, immediate threat of life/health and large expected benefits were the most preferred. Conversely, the positive version of social merit was an unappreciated rationing criterion.


1989 ◽  
Vol 67 (1) ◽  
pp. 31-34
Author(s):  
Michael D. Reagan

1992 ◽  
Vol 18 (1-2) ◽  
pp. 37-71
Author(s):  
Frances H. Miller

Health care rationing has gained greater visibility in the United States and the United Kingdom, for quite different reasons. As patients in both countries become more aware that potentially beneficial medical services can be denied them on economic — as opposed to purely medical — grounds, they are beginning to seek help from the judiciary. This Article contends that as rationing becomes more explicit, the doctrine of informed consent will come under increased pressure. The Article suggests that courts and legislatures consider imposing a legal obligation on physicians to inform their patients when potentially effective treatment is to be withheld for economic or other non-clinical reasons.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1294.1-1294
Author(s):  
C. Helin Hollstrand ◽  
K. Nilke Nordlund

Background:With the launch of The Swedish Young Rheumatics Report in April of 2018, we also presented new way of thinking and a tool called the Dreamscale, our complement to the traditional VAS scale used to assess pain. In October of 2018, we organized a workshop together with communication consults where we invited some of our members in different ages and health care professionals working with children, youths and young adults with rheumatic diseases, to try and reach a joint definition of what the Dreamscale is and could be, as we saw its huge potential. This is where the idea of the Dreamcatcher was born.Objectives:The objective is to create an innovative digital tool for young people with rheumatic disease. It takes its starting point in what is healthy and what is possible, rather than focusing on sickness and limitations. Using behavioral science, nudging and social functions, the Dreamcatcher has the potential to lower the barriers to living an active lifestyle, while also serving as a tool for dialogue with health care professionals, resulting in more efficient meetings, better resource planning and the gathering of valuable data to the national quality registers. It is also a digital tool with a big potential for development thanks to its open source code and its focus on enabling activity and participation, there is an obvious potential to develop its functions to also serve other actors and patient groups.Methods:We teamed up with communication bureau Gullers Grupp, pharmaceutical company Pfizer, and two health care clinics in Stockholm, one for children and youths with rheumatic disease and one for adults, and received funding for one year of development from Vinnova, the Swedish innovation authority, in April of 2019. We started the project by conducting a study to try and narrow down what focuses the Dreamcatcher should have. The pilot study contains both workshops with patients, both children, youths and young adults, and with teams of health care professionals, as well as more in-depth interviews with both patients and health care professionals. Based on the study, we will develop a prototype of what the Dreamcatcher could look like, and it will most likely be an application used for smartphones.Results:The study narrows down the Dreamcatcher into three things: the Dreamscale, Dream data, and the Dream collective.The Dreamscaleis as previously explained a complement to the traditional pain-scale and a tool for patients to set goals towards their dreams, and for patients and health care professionals to co-plan care and medical treatment based on what’s most important to the patient.Dream datais where patients can self-track their disease, data which is also available for the health care to view and therefore to be better prepared before meeting with the patient. It is also a goal to have the Dream data transferred to the national quality registers.The Dream collectiveis a social function where patients using the app can connect and get inspired by each other. It is a place to share your dreams and build a community to show that rheumatic disease isn’t something that should ever stop you from going after your dreams!Conclusion:The prototype of the Dreamcatcher will be presented in May of 2020 and we think this it has great potential to help shift focus withing health care, to not just focusing on sickness and limitations but rather on dreams, joy of life and possibilities!References:[1]https://ungareumatiker.se/nytt-digitalt-patientverktyg-unga-reumatiker-tar-fram-dromfangaren/[2]https://www.youtube.com/watch?v=zD6PwSKeb8IDisclosure of Interests:None declared


Science ◽  
1990 ◽  
Vol 248 (4956) ◽  
pp. 663-665
Author(s):  
H. Aaron ◽  
W. B. Schwartz

2018 ◽  
Author(s):  
Lisa McCann ◽  
Kathryn A McMillan ◽  
Christopher Hewitt

BACKGROUND A diagnosis of cancer in young adulthood can pose many different and unique challenges for individuals. The provision of adequate and appropriate information as well as care and support for teenagers and young adults at the time of diagnosis is central to their health care experience going forward. Moreover, appropriate and accessible information provision is critical to ensure that young individuals with cancer feel equipped and empowered to make decisions about, and be involved in, their treatment and recovery throughout their experience; this is a concept known as prehabilitation. As digital interventions and resources that support teenagers and young adults with cancer are an increasingly desirable part of health care provision, this study will focus on the development of an age- and population-appropriate electronic prehabilitation (e-Prehabilitation) system of care. OBJECTIVE We will conduct an exploratory, co-design research project that will inform the development of an e-Prehabilitation system of care to support teenagers and young adults diagnosed with cancer. A collaborative approach to data collection and prototype design will ensure that a patient-centered approach is embedded throughout. METHODS A qualitative, co-design study utilizing surveys, interviews, and focus group discussions is being conducted with teenagers and young adults, health care professionals, and technologists. RESULTS This research study is in progress; recruitment and data collection activities have commenced and findings are expected in early 2019. CONCLUSIONS The findings of this study will have important implications for informing the future development and evaluation of an e-Prehabilitation system of care to support teenagers and young adults diagnosed with cancer. REGISTERED REPORT IDENTIFIER RR1-10.2196/10287


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