ヘルス・ケアにおける医療資源の配分の可能性(<特集>看護の倫理とヘルスケアの本質)

抄録

The rationing of health care resources is identified as "the most important ethical issue" facing health care today. Economists divide the allocation into two levels, namely macro-allocation and micro-allocation. The former is the problem of apportioning of money among social needs, for example, for health care, education and military affairs. The latter is the allocation of health care resources at the level of the hospital. Advances in medical technology are the main factor contributing to the enlargement of medical needs and according to it the cost of health care has rapidly increased and there is no natural limit, as Daniel Callahan says, to the development of medical needs and technology, but the resources are limited. The problems concerning which principles we can apply to allocate limited health care resources present difficult questions concerning social justice.This issue may threaten the integrity of health care professionals and sacrificie care needs. This problem should be solved on the basis of a double integrity system, namely that of patients and the health care system, and for that reason the role of nursing professionals is very large.