Pawlson L G, Glover J J, Murphy D J
George Washington University School of Medicine, Washington, DC.
J Am Geriatr Soc. 1992 Jun;40(6):628-34. doi: 10.1111/j.1532-5415.1992.tb02117.x.
Geriatricians are faced with increasing pressure from insurers and the public to control costs. At the same time, subspecialist colleagues, patients, and the courts often demand ever more costly high-technology interventions. This conflict will only intensify given the sustained increase in the percentage of GNP spent on medical care. A number of prominent biomedical ethicists and others have explored rationing of medical care services as one response to these concerns. This is the second in a series of articles in the Journal in response to the Oregon Health Decisions Initiative and is designed to provide (1) a brief ethical perspective on rationing and allocation; (2) an analysis of our present, largely implicit, approach to rationing and allocation; and (3) some suggestions that might move the United States closer to a more coherent and reasonable means of allocating and rationing health care.
老年病医生面临着来自保险公司和公众日益增加的控制成本的压力。与此同时，专科医生同事、患者和法院常常要求采用成本更高的高科技干预措施。鉴于国民生产总值中用于医疗保健的百分比持续上升，这种冲突只会加剧。一些杰出的生物医学伦理学家和其他人探讨了医疗服务配给制，作为应对这些担忧的一种方式。这是《期刊》上一系列回应俄勒冈健康决策倡议的文章中的第二篇，旨在提供：（1）关于配给和分配的简要伦理视角；（2）对我们目前在很大程度上隐含的配给和分配方法的分析；以及（3）一些可能使美国更接近一种更连贯、合理的医疗保健分配和配给方式的建议。
