Can Health Care Rationing Ever Be Rational?
Version of Record online: 27 MAR 2012
© 2012 American Society of Law, Medicine & Ethics, Inc.
The Journal of Law, Medicine & Ethics
Volume 40, Issue 1, pages 17–25, Spring 2012
How to Cite
Gruenewald, D. A. (2012), Can Health Care Rationing Ever Be Rational?. The Journal of Law, Medicine & Ethics, 40: 17–25. doi: 10.1111/j.1748-720X.2012.00641.x
- Issue online: 27 MAR 2012
- Version of Record online: 27 MAR 2012
Americans' appetite for life-prolonging therapies has led to unsustainable growth in health care costs. It is tempting to target older people for health care rationing based on their disproportionate use of health care resources and lifespan already lived, but aged-based rationing is unacceptable to many. Systems reforms can improve the efficiency of health care and may lessen pressure to ration services, but difficult choices still must be made to limit expensive, marginally beneficial interventions. In the absence of agreement on principles to govern health care resource allocation, a fair, open priority-setting process should be created to allow for reasonable disagreement on principles while being seen as legitimate by all stakeholders. At the patient-care level, careful discussions about the benefits and burdens of medical intervention and support for slow medicine — a gentle, family-centered care approach for frail elders — can do much to avoid harming these patients with aggressive yet unwanted medical care while reducing wasteful spending.