Skip to main content
Journal of Medical Ethics logoLink to Journal of Medical Ethics
. 2004 Apr;30(2):207–211. doi: 10.1136/jme.2003.003681

Medical decision making in scarcity situations

J J M van Delden 1, A Vrakking 1, A van der Heide 1, P J van der Maas 1
PMCID: PMC1733845  PMID: 15082820

Abstract

The issue of the allocation of resources in health care is here to stay. The goal of this study was to explore the views of physicians on several topics that have arisen in the debate on the allocation of scarce resources and to compare these with the views of policy makers. We asked physicians (oncologists, cardiologists, and nursing home physicians) and policy makers to participate in an interview about their practices and opinions concerning factors playing a role in decision making for patients in different age groups. Both physicians and policy makers recognised allocation decisions as part of their reality. One of the strong general opinions of both physicians and policy makers was the rejection of age discrimination. Making allocation decisions as such seemed to be regarded as a foreign entity to the practice of medicine. In spite of the reluctance to make allocation decisions, physicians sometimes do. This would seem to be only acceptable if it is justified in terms of the best interests of the patient from whom treatment is withheld.

Full Text

The Full Text of this article is available as a PDF (173.6 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bonneux L., Barendregt J. J., Nusselder W. J., der Maas P. J. Preventing fatal diseases increases healthcare costs: cause elimination life table approach. BMJ. 1998 Jan 3;316(7124):26–29. doi: 10.1136/bmj.316.7124.26. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Callahan D. Terminating treatment: age as a standard. Hastings Cent Rep. 1987 Oct-Nov;17(5):21–25. [PubMed] [Google Scholar]
  3. Groenewoud J. H., van der Heide A., Kester J. G., de Graaff C. L., van der Wal G., van der Maas P. J. A nationwide study of decisions to forego life-prolonging treatment in Dutch medical practice. Arch Intern Med. 2000 Feb 14;160(3):357–363. doi: 10.1001/archinte.160.3.357. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Medical Ethics are provided here courtesy of BMJ Publishing Group

RESOURCES