Rationing Medical Care: Challenges in Bioethics

One of the most challenging questions that faces modern medical practice is that of rationing. It's an issue that patients, politicians, and doctor like to ignore, but that pervades every pore of medical practice. Daniel Callahan, a bioethics philosopher, has spent much of his life tackling the difficult questions that arise when we ask: What does it mean to ration care. In a recent NY Times article he noted that:

Existing medical care, he said, is “open-ended, progress-oriented and technology dependent.” Are we doomed, he wondered, to a relentless battle against death in which “nothing will ever count as success”? Won’t “aging societies, expensive technologies and rising expectations about the benefits of medicine” add up to “an impossible cost situation”?

As the population ages and our fascination with the newest (and often unproven) medical treatments grows, will our inability to objectively view medical care end up bankrupting the system? Some like Peter Singer have argued that we need to start considering age or quality of life gained from treatments as factors in delivering care (see the linked article for a deeper discussion of the concept). Other argue that we can stave off monetary disaster by constantly innovating our way out of trouble: better records, cheaper drugs, more doctors, more prevention, etc.

In the end we'll have to tackle rationing. Just not today.

Michael Shusterman is the Editor in Chief of TuftScope (2009 - 2010).