Skip to main content
NCBI home page
Journal of Medical Ethics logoLink to Journal of Medical Ethics
. 1999 Jun;25(3):224–229. doi: 10.1136/jme.25.3.224

Equitable rationing of highly specialised health care services for children: a perspective from South Africa.

W A Landman 1, L D Henley 1
PMCID: PMC479213  PMID: 10390676

Abstract

The principles of equality and equity, respectively in the Bill of Rights and the white paper on health, provide the moral and legal foundations for future health care for children in South Africa. However, given extreme health care need and scarce resources, the government faces formidable obstacles if it hopes to achieve a just allocation of public health care resources, especially among children in need of highly specialised health care. In this regard, there is a dearth of moral analysis which is practically useful in the South African situation. We offer a set of moral considerations to guide the macro-allocation of highly specialised public health care services among South Africa's children. We also mention moral considerations which should inform micro-allocation.

Full text

PDF
224

Selected References

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

  1. Benatar S. R. What makes a just healthcare system? BMJ. 1996 Dec 21;313(7072):1567–1568. doi: 10.1136/bmj.313.7072.1567. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Buchanan Allen. Privatization and just healthcare. Bioethics. 1995 Jul;9(3-4):220–239. doi: 10.1111/j.1467-8519.1995.tb00357.x. [DOI] [PubMed] [Google Scholar]
  3. Doyal L. Needs, rights, and equity: more quality in healthcare rationing. Qual Health Care. 1995 Dec;4(4):273–283. doi: 10.1136/qshc.4.4.273. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Halliday R. Medical futility and the social context. J Med Ethics. 1997 Jun;23(3):148–153. doi: 10.1136/jme.23.3.148. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Hugo-Hamman C. T., Vosloo S. M., De Moor M. M., Odell J. A. Paediatric heart transplants--should we do them? S Afr Med J. 1991 Nov 2;80(9):434–436. [PubMed] [Google Scholar]
  6. Hussey G. D., Lasser M. L., Reekie W. D. The costs and benefits of a vaccination programme for Haemophilus influenzae type B disease. S Afr Med J. 1995 Jan;85(1):20–25. [PubMed] [Google Scholar]
  7. Jecker N. S., Schneiderman L. J. Futility and rationing. Am J Med. 1992 Feb;92(2):189–196. doi: 10.1016/0002-9343(92)90111-n. [DOI] [PubMed] [Google Scholar]
  8. Kahn D. Supraregional funding for transplantation. S Afr Med J. 1994 Sep;84(9):590–591. [PubMed] [Google Scholar]
  9. Klein R. Priorities and rationing: pragmatism or principles? BMJ. 1995 Sep 23;311(7008):761–762. doi: 10.1136/bmj.311.7008.761. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Landman W. A., Henley L. D. Tensions in setting health care priorities for South Africa's children. J Med Ethics. 1998 Aug;24(4):268–273. doi: 10.1136/jme.24.4.268. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Marais A. D., Benatar S. R. Planning rational management of chronic diseases--lessons from a lipid clinic. S Afr Med J. 1995 May;85(5):340–341. [PubMed] [Google Scholar]
  12. McPherson M., Arango P., Fox H., Lauver C., McManus M., Newacheck P. W., Perrin J. M., Shonkoff J. P., Strickland B. A new definition of children with special health care needs. Pediatrics. 1998 Jul;102(1 Pt 1):137–140. doi: 10.1542/peds.102.1.137. [DOI] [PubMed] [Google Scholar]
  13. Viljoen D. L., Buccimazza S., Dunne T., Molteno C. The prevalence and prevention of neural tube defects in Cape Town. S Afr Med J. 1995 Jul;85(7):630–632. [PubMed] [Google Scholar]

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

RESOURCES