Naujausi A B C D E F G H I J K L M N O P R S T V W Y Z
Autoriai: PAUL T. MENZEL
Metai:
ISBN: 0-19-505710-4
Brūkšninis kodas: 4202189
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Anotacija:
In this superb book, Paul Menzel addresses the refractory problem of allocating limited health care resources. His central argument is that consent, or in its absence presumed consent, provides the justification for rationing health care. After establishing the conceptual basis for his theory, he tracks the implications of the theory for a wide range of problems including the pricing of life, malpractice, improving organ supply, treatment of imperiled newborns, persuading smokers to abstain and the duty to die cheaply. The writing is clear and accessible to the non-philosopher. For those entering this field, Menzel provides a framework for addressing a variety of questions in the allocation of health care. For the advanced scholar, he offers a coherent theory, with a candid presentation of its implications, which is certain to stimulate a host of critiques and refinements.
1. Could an economist take the Hippocratic oath? 3
The conflict 3
Solutions that fail 5
The prior consent of patients as persons 10
Objections and advantages 15
2. Presuming a patient’s consent to risk 22
Doubts and their importance 22
Comparisons with consent: Compensation 24
Presumed prior consent 29
3. Consent and the pricing of life 37
A historical sidelight: Life insurance 40
Wrongful death awards 41
The different case of Health-Care rationing 45
The rationality of consent 48
The treacherous use of empirical data 51
4. The costs of lifesaving: What if smoking saves money? 57
What counts as a cost of life? 57
The quick solution for smoking costs 60
Later Health-Care expenditures 62
Future earnings 65
Pensions 68
The limits of health promotion 71
Flu vaccine in nursing homes 73
5. Measuring quality of life 79
QALYs and how they work 80
Comparative quality and life itself 84
Hip replacements versus dialysis 87
Whom must we question? 89
The importance of length of life 92
6. The innocence of birth 97
Unimaginable bargains 99
Handicap insurance 101
The questionable relevance of consent 102
The asymmetry of nonexistence 106
Damages for wrongful life 108
7. The poor and the puzzle of equality 116
Medical egalitarianism 116
Inequalities and the value of life 119
Caring 121
Equal opportunity 122
The rational poor person 126
8. Real competition 132
What is really involved 133
The demise of regressive benevolence 135
Adverse selection and cream skimming 138
Telling patients about care withheld 144
9. Malpractice and the costs of complaint 150
Defensive medicine 151
A consent-based defense of expense 152
Assumption of risk 157
No-fault compensation for accidents of restraint 161
10. Raising transplants 169
Scarcity, not expense 169
Duty, not charity 172
Objecting versus consenting 174
The burden of expression 176
Families 179
Live donor selling 182
11. The duty to die cheaply 190
Disturbing costs 190
A personal moral duty 192
Rationing terminal care 196
Quasi-terminal care 199
References 205
Index 227
