Understanding the Scope of Clinical Ethics

摘要

In his investigation of healthcare and justice, Norman Daniels (2001, 2008) identifies three central questions, the last of which pertains to meeting healthcare needs justly in a resource-constrained environment. As Daniels’ extensive treatment of this subject demonstrates, if access to healthcare services indubitably depends upon available material resources, it must also be founded on a justificatory framework. This framework will not only guide current deliberations on provision and accessibility but will also serve as a guide to the just resolution of future problems. Meeting healthcare needs is a question of justice and equity and for this reason concerns surrounding resource allocation may appear to be meta-ethical with primarily social implications. However, as Foglia and colleagues’ target article (2009) makes clear, resource allocation decisions have a tangible impact on individuals that is often translated as a clinical or even a personal moral dilemma by clinicians. In this brief commentary, I want to discuss an important component of healthcare resourcemanagement that did not emerge in Foglia and colleagues’ discussion.