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Rationing - a Marginal Argument in the End of Life Debate?

Publication at Faculty of Mathematics and Physics, Faculty of Law |
2011

Abstract

Leaving the area of requesting assisted suicide or mercy killing aside, the question of defining the proper care in the terminal phase of an illness is supposed to be crucial. Indeed, to be confronted by patients and their families demanding a futile care actually seems to have become the part of everyday clinical practise of the doctors.

The health care provided to the patients at the last stages of their lives is considerably expensive - in accordance with the statistics available the expenditures paid for the treatment of dying patients represent the major category of the budget of the national health care systems in the developed countries. In a resource constrained system where the scarce resource situation occurs, the group of terminally ill might be at risk as far as rationing will be done only with respect to the criterion of life expectancy and cost effectiveness.

It is most unfortunate that according to some legal opinions the doctors use a futile care argument often as an explanation for the de facto rationing which is inevitably to be made by doctors but often because of the eventual criminal consequences not to be admitted at the same time.