Compassionate Care: Towards a New Ethical Approach for Allocating Healthcare Resources Público

Ferry, Lucia (Spring 2023)

Permanent URL: https://etd.library.emory.edu/concern/etds/1c18dh17b?locale=pt-BR
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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

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