Abstract:
:In healthcare, a tension sometimes arises between the injunction to do as much good as possible with scarce resources and the injunction to rescue identifiable individuals in immediate peril, regardless of cost (the "Rule of Rescue"). This tension can generate serious ethical and political difficulties for public policy makers faced with making explicit decisions about the public funding of controversial health technologies, such as costly new cancer drugs. In this paper we explore the appropriate role of the Rule of Rescue in public resource allocation decisions by health technology funding advisory bodies such as the National Institute for Health and Clinical Excellence. We consider practical approaches to operationalising the Rule of Rescue from Australia and the UK before examining the relevance of individual moral imperatives to public policy making. We conclude that that whilst public policy makers in a humane society should facilitate exceptional departures from a cost effectiveness norm in clinical decisions about identified individuals, it is not so obvious that they should, as a matter of national public policy, exempt any one group of unidentified individuals within society from the rules of opportunity cost at the expense of all others.
journal_name
J Med Ethicsjournal_title
Journal of medical ethicsauthors
Cookson R,McCabe C,Tsuchiya Adoi
10.1136/jme.2007.021790subject
Has Abstractpub_date
2008-07-01 00:00:00pages
540-4issue
7eissn
0306-6800issn
1473-4257pii
34/7/540journal_volume
34pub_type
杂志文章,评审abstract::The present and future rapid increase in the hospital population of geriatric patients is discussed with particular reference to the problem of advanced brain degeneration. The consequences of various clinical management options are outlined and it is suggested that extreme attempts either to preserve or terminate lif...
journal_title:Journal of medical ethics
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abstract::Two protechnology arguments, the "hopeful principle" and the "automatic escalator", often used in bioethics, are identified and critically analysed in this paper. It is shown that the hopeful principle is closely related to the problematic precautionary principle, and the automatic escalator argument has close affinit...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.2006.016477
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abstract::Albertsen, in his recent article, offers an assessment of the recently introduced opt-out system for organ donation in Wales. However, he focuses on whether concerns raised prior to the enactment of the new system have been realised, rather than any positive impact on the number of actual donors. This side-lining of t...
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pub_type: 评论,杂志文章
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journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.8.3.144
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abstract::Currently, any dentist in the UK who is HIV-seropositive must stop treating patients. This is despite the fact that hepatitis B-infected dentists with a low viral load can continue to practise, and the fact that HIV is 100 times less infectious than hepatitis B. Dentists are obliged to treat HIV-positive patients, but...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.2007.021972
更新日期:2008-03-01 00:00:00
abstract::The increasing availability of DNA-based diagnostic tests has raised issues about whether these should be applied to the population at large in order to identify, treat or prevent a range of diseases. DNA tests raise concerns in the community for several reasons. There is the possibility of stigmatisation and discrimi...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.25.2.209
更新日期:1999-04-01 00:00:00
abstract::More than 25 years into the HIV epidemic, in excess of 2 million new infections continue to occur each year. HIV prevention research is crucial for groups at heightened risk for HIV, but the design and conduct of HIV prevention research with vulnerable populations worldwide raises considerable ethical challenge...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.2010.035444
更新日期:2010-12-01 00:00:00
abstract:OBJECTIVES:To analyse the decision making for end of life care for patients with cancer at a teaching hospital in Japan at two periods 10 years apart. DESIGN AND SETTING:Retrospective study conducted in a 550 bed community teaching hospital in Okinawa, Japan. PATIENTS:There were 124 terminally ill cancer patients (45...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.2003.000125
更新日期:2004-06-01 00:00:00
abstract::This point of view compares the issue of informed patient consent primarily as it operates in Australia and the United Kingdom. It affords an overview, also, of the applicable law in the United States and Canada. It particularly focuses on the legal test to be applied to patient consent as established in the Bolam cas...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.21.1.5
更新日期:1995-02-01 00:00:00
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journal_title:Journal of medical ethics
pub_type: 杂志文章
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更新日期:2009-11-01 00:00:00
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journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.16.3.146
更新日期:1990-09-01 00:00:00
abstract::Some disability rights advocates criticise prenatal testing and selective abortion on the grounds that these practices express negative attitudes towards existing persons with disabilities. Disability rights advocates also commonly criticise and oppose physician-assisted suicide (PAS) and euthanasia on the same ground...
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pub_type: 杂志文章
doi:10.1136/medethics-2019-105875
更新日期:2020-08-01 00:00:00
abstract::Obstetricians face difficult decisions when the interests of fetus and mother conflict. An example is the problem of choosing the delivery method when labour begins prematurely and the fetus is breech. Vaginal delivery involves risks for the breech fetus of brain damage or death caused by umbilical cord compression an...
journal_title:Journal of medical ethics
pub_type: 杂志文章,评审
doi:10.1136/jme.14.1.18
更新日期:1988-03-01 00:00:00
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journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.2004.010553
更新日期:2005-09-01 00:00:00
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journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.19.2.71
更新日期:1993-06-01 00:00:00
abstract::Medical student and resident participation in global health experiences (GHEs) has significantly increased over the last decade. In response to growing student interest and the proven impact of such experiences on the education and career decisions of resident physicians, many medical schools have begun to establish p...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.2006.019265
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVES:A statute enacted in 2005 modified the legislative framework of the rights of terminally ill persons in France. Ten years after the EURONIC study, which described the self-reported practices of neonatal caregivers towards ethical decision-making, a new study was conducted to assess the impact of the new law ...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.2010.038356
更新日期:2011-04-01 00:00:00
abstract::Despite concerns about the relationships between health professionals and the medical device industry, the issue has received relatively little attention. Prevalence data are lacking; however, qualitative and survey research suggest device industry representatives, who are commonly present in clinical settings, play a...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2018-104804
更新日期:2018-09-01 00:00:00
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journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.6.3.120
更新日期:1980-09-01 00:00:00
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journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2012-101290
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journal_title:Journal of medical ethics
pub_type: 评论,杂志文章
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pub_type: 杂志文章,评审
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pub_type: 杂志文章,多中心研究
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更新日期:2011-09-01 00:00:00
abstract:OBJECTIVE:The President's Council on Bioethics in 2008 reaffirmed the necessity of the dead donor rule and the legitimacy of the current criteria for diagnosing both neurological and cardiac death. In spite of this report,many have continued to express concerns about the ethics of donation after circulatory death, the ...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2013-101333
更新日期:2014-07-01 00:00:00
abstract::The paper comments on Scott Dunbar's "An obstructed death and medical ethics," arguing contra Dunbar that we should not view truth-telling to the terminally ill as primarily governed by principles of veracity and respect for autonomy. All such rules are of limited value in medical ethics. We should instead turn to a...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.16.2.88
更新日期:1990-06-01 00:00:00
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journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.2009.034041
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVES:To explore British community pharmacists' views on PAS, including professional responsibility, personal beliefs, changes in law and ethical guidance. DESIGN:Postal questionnaire. SETTING:Great Britain. SUBJECTS:A random sample of 320 registered full-time community pharmacists. RESULTS:The survey yielded ...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.26.5.363
更新日期:2000-10-01 00:00:00
abstract::In the context of military medical care, Eisenstein and colleagues have introduced the notion 'left of bang intervention in trauma', which refers to interventions administered before trauma to reduce morbidity and mortality after injury. This paper responds to Eisenstein and colleagues' ethical analysis of such interv...
journal_title:Journal of medical ethics
pub_type: 评论,杂志文章
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更新日期:2018-07-01 00:00:00
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pub_type: 杂志文章
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更新日期:2018-08-01 00:00:00
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journal_title:Journal of medical ethics
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更新日期:2004-10-01 00:00:00