Abstract
In many countries, a gap exists between the population's need for health care and available resources. These nations have attempted to eliminate or reduce the gap through such activities as improving efficiency and narrowing responsibilities. Since these measures have proven insufficient, decisions must be made regarding how to best use the scarce resources. The priority-setting and rationing processes involve key decisions in the sense that they have consequences for people's health and quality of life and they should therefore be rational and based on solid grounds. This means that the decisions involve three issues: facts, concepts and values. In this presentation the focus is on the conceptual and value issues. A basic ethical platform as a guide for decision-making will be presented. The ethical principles that constitute the platform contain central concepts like health care need, cost-effectiveness, health and goal. A short presentation of these concepts will be carried out. This will end with the concept of a goal and its importance for decision-making.
Highlights
In many countries, a gap exists between the population’s need for health care and available resources
If we adopt an ethical platform as a guideline for setting of priorities in health care, some concepts come into focus
The concept of health care need became more interesting in this light
Summary
A gap exists between the population’s need for health care and available resources These nations have attempted to eliminate or reduce the gap through such activities as improving efficiency and narrowing responsibilities. Because the decisions sometimes concern life and death, we want them to be rational and based on solid grounds This means that we want decisions to be based on facts, concerning, for instance, health care needs or the relative effectiveness of different treatments. Different views exist on what should constitute a value base for decisions concerning the allocation of health care. It begins with an analysis of the concepts of allocation, prioritization, and rationing, and proceeds with a presentation of the value base that was implemented through the Swedish Health Care Act. A central principle in this value base is need. A consistent conceptual structure will reduce the risk for confusion
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