Rationing, Fruglaity, Ethics

New England Journal of Medicine
May 24, 2012  Vol. 366 No. 21
http://content.nejm.org/current.shtml

Perspective
From an Ethics of Rationing to an Ethics of Waste Avoidance
H. Brody
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Bioethics has long approached cost containment under the heading of “allocation of scarce resources.” Having thus named the nail, bioethics has whacked away at it with the theoretical hammer of distributive justice. But in the United States, ethical debate is now shifting from rationing to the avoidance of waste. This little-noticed shift has important policy implications…

Beyond the “R Word”? Medicine’s New Frugality
M.G. Bloche
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Quietly, Washington policymakers have begun to concede the need to weigh health care’s benefits against its costs if our country is to avert fiscal ruin. That costs must be counted against benefits is common sense in other domains — and among health policy professionals. But it’s anathema in public discussion of medical care. To silence talk of tradeoffs, politicians invoke the “R word” — rationing…