Compassionate Care: Towards a New Ethical Approach for Allocating Healthcare Resources Público
Ferry, Lucia (Spring 2023)
Abstract
In a world of finite resources, how do we decide who deserves what in health care? Do we decide to spread the resources amongst people that will create the greatest overall population? Or do we allocate them to those who need it most? Do we concern ourselves with the well-being of the individual patient or society as a whole?
One approach taken by health economists is simply aiming to increase overall population health statistics using efficiency. However, this utilitarian approach does not do enough to recognize humanity as its focus is almost entirely on the numbers. By recognizing the importance of individuals within the system, we can provide individualized care that improves the dignity and respect afforded to patients. However, this cannot be solved by simply prioritizing the absolute duty to each individual patient over all else as Kant would argue since there will always come a point when decisions must be made between the duties to each patient.
Reconciling compassionate, individualized care with the goal of efficiency, the Dalai Lama’s ethics of compassion addresses the shortcomings of the utilitarian and deontological approaches to research allocation. The approach taken by the United Kingdom’s National Institute for Clinical Excellence aligns with this ethics of compassion since its guidelines first fall back on consequentialism, but in hard cases medical professionals can apply these guidelines based on the individual circumstances of the patient.
By applying an ethics of compassion, systems can become closer to finding a proper balance between the ‘inconsistent triad’ of cost, quality, and access in healthcare. The application of the ethics of compassion to decisions regarding resource allocation must be supported by a compassionate healthcare system. With these improved decision-making modes and compassionate systems that similarly aim to respect the dignity of individual patients, healthcare systems can take important steps towards creating an improved sense of justice in healthcare.
Table of Contents
Introduction
Chapter Overview
Chapter 1: Utilitarianism & Healthcare Economics
Introduction
Defining Health & Healthcare
Importance of Ethical Guidelines in Making Health Care Decisions
The Role of Priority Setting in Health Care
Health Economics & Utilitarianism
Quality-Adjusted Life Years
The Problems with Quantifying Life using QALYs
Conclusion
Chapter 2: Deontological Ethics & Prioritizing the Duty to the Individual Patient
Introduction
The Problem of Supply & Demand for Individuals: The Case of Child B
Deontological Ethics & Morality
Duties in Healthcare
The Right to Healthcare
The Doctor-Patient Relationship Individualism & Autonomy Quality Care for All Costs Conclusion
Chapter 3: Towards Solving the Inconsistent Triad of Healthcare
Introduction Access, Quality, and Cost: An Inconsistent Triad
US Healthcare vs. National Health Service
A World of Conflicting Values
A NICE Solution: The National Institute for Health and Care Excellence
Concerns about NICE Conclusion
Chapter 4: The Ethics of Compassion
Introduction
The Ethics of Compassion
Compassion & Patient-Centered Care
Efficiency & Patient-Centered Care
The Effects of Compassion on Healthcare Providers
Compassion Training
Implementing Compassion on a Large Scale
Conclusion
Conclusion
Introduction
The New Models’ Incompatibility with American Healthcare
The Larger Solution: Changing the System
An Attempt at Changing the System: The Affordable Care Act
Systems Affect Individuals
Conclusion
About this Honors Thesis
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