Public Good versus Private "Goods": Ethical Implications of Drug Shortages on Anesthesiology Practice.

Drug shortages remain a serious and widespread problem affecting all health systems and patients. Anesthesiology practice is strongly impacted by shortages of sterile injectable drugs, resulting in a negative impact on the quality of care. Understanding the root causes of drug shortages guides the anesthesiologist toward an ethical response. While rationing is a common consideration in secular ethics, and indeed rationing strategies are utilized, the use of rationing alone risks normalizing and perpetuating the drug shortage problem. Drug shortages are the direct result of a market failure brought on by lack of oversight of drug production standards in some cases as well as by the impact of intermediary purchasing groups on costs and availability of drugs. Legislation needs to reestablish a responsible, competitive, and robust manufacturing drug market.