Roman Catholic moral theology is the point of departure for this multifaceted exploration of the challenge of allocating scarce medical resources. The volume begins its exploration of discerning moral limits to modern high-technology medicine with a consensus statement born of the conversations among its contributors. The seventeen essays use the example of critical care, because it offers one of the few areas in medicine where there are good clinical predictive measures regarding the likelihood of survival. As a result, the health care industry can with increasing accuracy predict the probability of saving lives—and at what cost. Because critical care involves hard choices in the face of finitude, it invites profound questions about the meaning of life, the nature of a good death, and distributive justice. For those who identify the prize of human life as immortality, the question arises as to how much effort should be invested in marginally postponing death. In a secular culture that presumes that individuals live only once, and briefly, there is an often-unacknowledged moral imperative to employ any means necessary to postpone death. The conflict between the free choice of individuals and various aspirations to equality compounds the challenge of controlling medical costs while also offering high-tech care to those who want its possible benefits. It forces society to confront anew notions of ordinary versus extraordinary, and proportionate versus disproportionate, treatment in a highly technologically structured social context. This cluster of discussions is enriched by five essays from Jewish, Orthodox Christian, and Protestant perspectives. Written by premier scholars from the United States and abroad, these essays will be valuable reading for students and scholars of bioethics and Christian moral theology.

Disasters and public health emergencies can stress health care systems to the breaking point and disrupt delivery of vital medical services. During such crises, hospitals and long-term care facilities may be without power; trained staff, ambulances, medical supplies and beds could be in short supply; and alternate care facilities may need to be used. Planning for these situations is necessary to provide the best possible health care during a crisis and, if needed, equitably allocate scarce resources. Crisis Standards of Care: A Toolkit for Indicators and Triggers examines indicators and triggers that guide the implementation of crisis standards of care and provides a discussion toolkit to help stakeholders establish indicators and triggers for their own communities. Together, indicators and triggers help guide operational decision making about providing care during public health and medical emergencies and disasters. Indicators and triggers represent the information and actions taken at specific thresholds that guide incident recognition, response, and recovery. This report discusses indicators and triggers for both a slow onset scenario, such as pandemic influenza, and a no-notice scenario, such as an earthquake. Crisis Standards of Care features discussion toolkits customized to help various stakeholders develop indicators and triggers for their own organizations, agencies, and jurisdictions. The toolkit contains scenarios, key questions, and examples of indicators, triggers, and tactics to help promote discussion. In addition to common elements designed to facilitate integrated planning, the toolkit contains chapters specifically customized for emergency management, public health, emergency medical services, hospital and acute care, and out-of-hospital care.

The question of how to allocate scarce medical resources has become an important public policy issue in recent decades. Cost-utility analysis is the most commonly used method for determining the allocation of these resources, but this book counters the argument that overcoming its inherent imbalances is simply a question of implementing methodological changes. The Economics of Resource Allocation in Health Care represents the first comprehensive analysis of equity weighting in health care resource allocation that offers a fundamental critique of its basic framework. It offers a critique of health economics, putting the discourse on economic evaluation into its broader socio-political context. Such an approach broadens the debate on fairness in health economics and ties it in with deeper-rooted problems in moral philosophy. Ultimately, this interdisciplinary study calls for the adoption of a fundamentally different paradigm to address the distribution of scarce medical resources. This book will be of interest to policy makers, health care professionals, and post-graduate students looking to broaden their understanding of the economics of the health care system.

Examines how the framing of disability has serious implications for legal, medical, and policy treatments of disability.

In the past few years an increasing number of colleges and universities have added courses in biomedical ethics to their curricula. To some extent, these additions serve to satisfy student demands for "relevance. " But it is also true that such changes reflect a deepening desire on the part of the academic community to deal effectively with a host of problems which must be solved if we are to have a health-care delivery system which is efficient, humane, and just. To a large degree, these problems are the unique result of both rapidly changing moral values and dramatic advances in biomedical technology. The past decade has witnessed sudden and conspicuous controversy over the morality and legality of new practices relating to abortion, therapy for the mentally ill, experimentation using human subjects, forms of genetic interven tion, suicide, and euthanasia. Malpractice suits abound and astronomical fees for malpractice insurance threaten the very possibility of medical and health-care practice. Without the backing of a clear moral consensus, the law is frequently forced into resolving these conflicts only to see the moral issues involved still hotly debated and the validity of existing law further questioned. In the case of abortion, for example, the laws have changed radically, and the widely pub licized recent conviction of Dr. Edelin in Boston has done little to foster a moral consensus or even render the exact status of the law beyond reasonable question.

The COVID-19 pandemic has affected every human being on the planet and forced us all to reflect on the bioethical issues it raises. In this timely book, Gregory Pence examines a number of relevant issues, including the fair allocation of scarce medical resources, immunity passports, tradeoffs between protecting senior citizens and allowing children to flourish, discrimination against minorities and the disabled, and the myriad issues raised by vaccines.

What should happen when doctors and parents disagree about what would be best for a child? When should courts become involved? Should life support be stopped against parents' wishes? The case of Charlie Gard, reached global attention in 2017. It led to widespread debate about the ethics of disagreements between doctors and parents, about the place of the law in such disputes, and about the variation in approach between different parts of the world. In this book, medical ethicists Dominic Wilkinson and Julian Savulescu critically examine the ethical questions at the heart of disputes about medical treatment for children. They use the Gard case as a springboard to a wider discussion about the rights of parents, the harms of treatment, and the vital issue of limited resources. They discuss other prominent UK and international cases of disagreement and conflict. From opposite sides of the debate Wilkinson and Savulescu provocatively outline the strongest arguments in favour of and against treatment. They analyse some of the distinctive and challenging features of treatment disputes in the 21st century and argue that disagreement about controversial ethical questions is both inevitable and desirable. They outline a series of lessons from the Gard case and propose a radical new 'dissensus' framework for future cases of disagreement. - This new book critically examines the core ethical questions at the heart of disputes about medical treatment for children. - The contents review prominent cases of disagreement from the UK and internationally and analyse some of the distinctive and challenging features around treatment disputes in the 21st century. - The book proposes a radical new framework for future cases of disagreement around the care of gravely ill people.