Elkowitz A
J Natl Med Assoc. 1986 May;78(5):423-7.
In the past the study of the allocation of scarce medical resources centered around "high-tech" forms of health care, such as the use of the artificial heart and hemodialysis. The use of nonbiomedical criteria (ie, should the social worth or financial status of a particular patient dictate preferential treatment over another patient in times of shortage) in the allocation decision-making process may be at times highly controversial.The study of allocation need not only lie in the dramatic realm of high technology, but should also be directed to the less dramatic, everyday situations. Decisions concerning treatment based upon social worth and financial status are made almost daily by practitioners. A thorough understanding of this phenomenon is tantamount to the ethical and proper practice of medicine.
过去，对稀缺医疗资源分配的研究主要围绕“高科技”医疗形式展开，比如人工心脏的使用和血液透析。在分配决策过程中使用非生物医学标准（即，在资源短缺时，特定患者的社会价值或经济状况是否应决定其比其他患者获得优先治疗）有时可能极具争议性。对分配的研究不仅应着眼于高科技这一引人注目的领域，还应针对那些不那么引人注目的日常情况。从业者几乎每天都会基于社会价值和经济状况做出有关治疗的决策。透彻理解这一现象等同于医学的道德且恰当实践。
