Essay on Healthcare Rationing

Healthcare rationing is the systematic allocation of limited care resources. Resources may include all materials, personnel, facilities, funds, and anything that can be used to provide health care service. Millions of people continue to have limited access to healthcare, and the cost associated to healthcare have increased due to technological advancement (Ransom & Olsson 2017). Rationing of care is sometimes a necessity because resources to support healthcare are limited. There are people that are insured, and some people are not; which means only a percentage of the population can receive the necessary care. Another term for rationing is resource allocation (Finkelman, 2019).

Healthcare rationing extends to the insurance companies and state funded healthcare coverages like Medicare and Medicaid; they determine which part of care they cover based on predetermined standards they have set for their consumers. An example of rationing that should be addressed is that of organ transplantation. There is a database that has been set up for patients waiting for organ donation. To qualify, certain standards must be met; criteria like age, illnesses or economic status of said individual can be a determinant factor on whether one gets an organ or not. (Finkelman, 2019).

One of the most important question to ask is which potential the ethical principles are related to healthcare rationing? There are several ethical principles to be considered, some of which are the principles of beneficence, autonomy, justice, and advocacy.

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A component of our roles as healthcare workers is our critical thinking skills. Physicians are encouraged to ration care based on which medications they prescribe, or the level of resources they can allocate to the treatment of patients. For instance, in a case study from the AMA journal of ethics about a 58 years old black homeless man suffering from end stage kidney disease. Mr. J was a homeless man with some psychological issues who preferred to live on the street.

During the cold winter months, Mr. J would later become one of the patients in the emergency department that were termed “frequent flyers”. Mr. J’s dialysis is usually administered during his frequent visits to the hospital after which he goes right back to the street. Mr. J was not compliant with his medication or diet; his lifestyle choice invariably contributed to his deteriorating health. Invariably, all the personnel involved in his care started viewing him as a manipulative individual that was just taking advantage of the system. (Rosoff, 2017)

The situation of health care rationing came into play in Mr. J’s situation, people that were directly involved in his care agreed that the hospital resources should be conserved and reallocated (Rosoff, 2017). The situation questions our ethical principle of beneficence which encompasses doing something good and caring for the patient. Beneficence means doing no harm and protecting one’s patient regardless of the patient’s economic status.

Healthcare professionals cannot lose site of the oath that was taken not to do any harm, while it may be necessary to ration care; we need to be sure the resources are in short supply and not to the detriment of our patients. Mr. J’s physicians all wish to switch him to hospice care, a decision that will likely ignore his right to autonomy since Mr. J wishes to continue receiving his dialysis (Rosoff, 2017).

The fact here is that Mr. J is probably not at the top of any kidney recipient database because of his age, economic situation and lifestyle. Donor kidney for Mr. J is scarce compared to his continuous dialysis treatment. While resources may be scarce, we as healthcare professionals cannot let our judgment play any role in how we treat patients like Mr. J. it is not our place to deprive him of his right to make healthcare decision especially if he has the mental capacity to do so.

Our ethical principle of justice dictates that we do not discriminate, whether the patient is Mr. J, or a rich white Mr. K that comes into our facilities, we need to be fair and give both patients the required quality of care. Rationing does not mean playing “God” with people’s life. The goal is to distribute healthcare resources evenly without sacrificing the quality of care.

The ethical principle of advocacy involves safeguarding our patient’s right. Advocacy means ensuring our patients’ rights are protected. Healthcare workers cannot abuse that right, it is our job to advocate for everyone in our care regardless of their status. When we intervene in our patient’s care, it needs to be done to the best of our ability as health professional, without malice or prejudice.

In conclusion, we live in a world where our resources are limited, and rationing may be necessary. “Rationing” may be viewed as a negative word but it is sometimes essential when acting for the benefit of the masses; however, rationing because of prejudice against a demographic of people should be addressed. We as healthcare professionals need to learn to ignore irrelevant qualities like gender, age, skin color or other attributes that may prevent us from being able to follow our basic ethical principles of advocating for our patients when necessary; respecting their autonomy and lastly, the principle of justice for all.

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