Should ethics consultants help clinicians face scarcity in their practice?: Figure 1

Abstract

In an international survey of rationing we have found that European physicians encounter scarcity-related ethical difficulties, and are dissatified with the resolution of many of these cases. Here we further examine survey results to explore whether ethics support services would be potentially useful in addressing scarcity related ethical dilemmas. Results indicate that while the type of help offered by ethics support services was considered helpful by physicians, they rarely referred difficulties regarding scarcity to ethics consultation. We propose that ethics consultants could assist physicians by making the process less difficult, and by contributing to decisions being more ethically justifiable. Expertise in bringing considerations of justice to bear on real cases could also be useful in recognising an unjust limit, as opposed to a merely frustrating limit. Though these situations are unlikely to be among the most frequently referred to ethics support services, ethics consultants should be prepared to address them.

Public health: How much evidence is needed to support our policies?

“…Indeed, public health ethics, the examination of the ethical issues arising in public health and health policy, is currently receiving growing attention as its specificities become clearer. 16 At minimum, we should certainly not attempt such decisions if we are shirking discussion of the values involved, 19 including values that could help us decide when enough evidence is available. 12 We should be aware that all of these questions involve thresholds, and that we have no entirely objective manner of defining where those thresholds ought to be.…”

EAES recommendations on methodology of innovation management in endoscopic surgery

“…Too little, i.e., undertreatment, as well as too much treatment (''futility'') represent two sides of this coin [58,59]. Respecting the principle of justice in health care includes actively maintaining an attitude of fairness, especially toward those with greater needs, and using resources carefully in order to avoid unnecessary burdens to patients and society [60].…”

Clinical ethics consultation service at the Ev. Krankenhaus Bielefeld – Background, concepts and strategies for evaluation

“…Kostenersparnis könnte dann -neben anderen -zur Bewertung einer Ethikberatung dienen, wenn ausgewiesen wird, dass Ressourcen dank der Ethikberatung ethisch sinnvoller eingesetzt werden kön-nen; dies wird jedoch deshalb seltener der Fall sein, weil Ethikkonsile bisher nicht regelmäßig zur Klärung von Fragen der Zuteilung von Ressourcen dienen; dies könnte sich in Zukunft ändern [13].…”