Halper T
Milbank Mem Fund Q Health Soc. 1985 Winter;63(1):52-93.
The uniquely parsimonious approach to treatment of end-stage renal disease patients in the U.K. was initially developed under the imprimatur of the nation's medical elite and sanctioned by the central government. Public value for public money and an equitable balance of scarce resources among many social and medical claims still guide the National Health Service. But these clinically dominated allocative decisions are imperfect, often counter-productive, and, ultimately, political. There is a marked dissonance between compassionate and bureaucratic themes.
在英国，针对终末期肾病患者独特而简约的治疗方法最初是在该国医学精英的认可下制定的，并得到了中央政府的批准。公共资金的公共价值以及在众多社会和医疗需求之间公平分配稀缺资源，仍然是国民医疗服务体系的指导原则。但这些由临床主导的分配决策并不完美，往往适得其反，而且最终是政治性的。在人道关怀与官僚主义主题之间存在明显的不协调。
