Doctors and rationing: the end of the honor system.

Physicians have traditionally held that to participate in "rationing" or resource allocation would betray their duty to advocate for everything possible for the patient. However, the record of physician behavior belies that, indicating instead that they have always rationed health care and their own time and services. Physician resistance to calls for "rationing" today appears to be based more on the nature of the process and on the fact that this process is being taken out of the hands of physicians. If American medicine does not rethink its own stance and develop not only a stronger resource allocation ethic but also a means of implementing it, it is unlikely that physicians will continue as the guardians of the quality of care and patient service.