LC567 Ethical Issues in Social Science Assignment Sample

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Introduction

Healthcare rationing upholds the notion of varied debates and concerning components within the health economics. It refers to the allocation of healthcare resources that are scarce by nature and using it for different approaches with the motive of delivering patient care (Berezowski et al, 2023). Despite facing criticism, the process holds potential benefits for society as it is contributing in adopting a sustainable approach and consequently, resources have been protected. Rationing is certainly unavoidable because the needs are consistently increasing and in comparison, the resources are limited. Ethical reasoning and morals are pivotal in healthcare specifically in complex areas that concerned with the delivery of healthcare services. Studies have shown that, rationing in healthcare felt to be unfair, it highlights the potential discriminatory attributes due to which ethical dilemmas are rising to greater extent (Aziz and Brandl, 2021).

The present report will critically analyse the concept “Rationing of healthcare’ by underpinning the ethical dilemmas and ethical theories. In-depth evaluation would be done and accordingly positive and negative elements will be analysed. Furthermore, multiple viewpoints adhering with rationing will be described and accordingly, conclusive statement will be made. Moreover, personal reflection will be written for highlighting own learning, values and influence on professional practice. Students seeking help in writing assignments can use this report as a reference to understand the ethical complexities surrounding healthcare rationing. The report will use the term rationing and resource allocation synonymously for undertaking critical analysis.

Background of the chosen topic

Rationing revolves around one central idea; repudiating a potential beneficial treatment to patient on the grounds of scarcity. However, undertaking such treatment that comprised with certain benefits are essential as there is no alternative option that can improve patient health outcomes. The decision of rationing pervading on regular basis in ICUs, physicians often ration their time and interaction with patient, service provider takes decision whether to see which patient first and last (Bognar and Hirose, 2022). The social goods are drawing funds from common pool, requirement for these goods is limitless whereas, the supply is less. In context of healthcare goods, the situation is critical, meeting all health-care needs ultimately impacts other components of social goods that are aligned with education, defense and public safety. Thereby, up-to some degree rationing within healthcare is necessary so that well-being of the society can be maintained. The scarcity of healthcare resources in recent years specifically in COVID period has shifted the attention of policy makers in rationing.

LC567 Ethical Issues in Social Science Assignment Sample

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George Clark 9 Years | LLB

The economic rationality of the rationing within healthcare system raising the cost of care consistently (ALMesned et al, 2021). The modern healthcare sector focuses on present as well as future needs and therefore, resource allocation is considered as topmost element. In the public sector, specifically in Medicaid and the Hospital Emergency rooms, healthcare is rationed due to high patient copayment, discouraging for providing certain services, long waits and less payment to doctors. However, controversies highlight that rationing in healthcare is influencing the lives of present generation for saving the resources which is an unethical attribute.

The Human Rights Act 1998 signifies about the right of each individual and healthcare is one of them mandatory rights. In accordance with this legislation, it is essential to provide healthcare services to people (UK Legislations, 2022). Dignity, respect, fairness, independence and equality are the major components of Human right act that requires to be undertaken while delivering healthcare services to patient (UK Legislations, 2022). However, healthcare rationing is contradicting with this legislation, it has been subjected to discrimination due to which this concept facing consistent criticism. The underprivileged groups in the community are not able to gain necessary services due to rationing and the richer section of society receives quality healthcare services as they have the potential to pay expenses. This is signifying about the gaps existing in society, rationing is impacting certain groups rather than whole society and this makes it a concerning element.

Ethical Perspective

Public engagement and transparency seem indispensable in ethical context, criticism of the rationing states that there are emotionally and morally difficult choices has been made by resource allocation (Eijkholt et al, 2021). The society is unable to find the alternative solution of scarcity and subsequently, healthcare rights of people are impacted. Utilitarianism ethical theory focuses on taking such actions that promotes happiness and well-being, the ultimate motive of this theory entails with encouraging greatest number of goods in the society. The utilitarianism belief in healthcare saves the lives of patient by considering that treatment option which enhances patient health outcomes (Brendbekken et al, 2022). However, rationing comes up with denying of certain treatments and not considering patient interest. Societal interest is prioritised and individual interest has been ignored, this is raising concern regarding ethics. The fundamental motive of healthcare is to prioritise the needs of patients for enhancing their health outcomes and similarly, utilitarianism focuses on this context. However, rationing of healthcare services creating dissatisfaction in patient and this is not adhering with utilitarianism belief.

Deontology theory focuses on rules and protocols for verifying about the right and wrong aspects. In accordance with this healthcare rationing is duty-based attribute which is essential for managing the scarcity of resources. If resources are not protected then, this lead to develop devasting situation just like COVID-19 and therefore, policy makers have undertaken the economic rationing via incorporation of healthcare rationing (Brendbekken et al, 2022). On the other hand, consequentialism ethical theory focuses on results and then judge whether the taken actions are morally correct or not. For instance- if a patient is denied for a treatment and it impacts his/her health in negative manner then, it can be said that healthcare rationing is creating ethical dilemma (Robertson, 2022). The results signifying about the neglection of patient health and apparently, health outcomes are impacted in negative manner.

This is raising conflict between individual rights and public goods; healthcare rationing is specifically for promoting societal good by saving the resources. Whereas, it is impacting individual rights by impacting the healthcare rights of patients. In the opinion of Moosa et al, (2021) scarcity of healthcare resources and consistently rise in the demand of healthcare services specifying about the need of healthcare rationing. However, Hancock and Mackey (2020) stated that decision making related to healthcare rationing should be adhered with economic evaluation and the loopholes requires to be focused out. For example- individuals who belongs from lower socio-economic background must be given healthcare rights with regards to their treatment procedure as service providers denies by themselves in the pursuit of healthcare rationing. Refusal of treatment in mandatory situation creates distressing situation and this is specifically faced by poor people as they need to rely on public services. Henceforth, equality should be promoted and rationing must be incorporated for all sections within the society. There is uneven distribution of resources in the society due to which richer section gets all the services while poorer section struggle with basic healthcare needs and implication of rationing creates distressing circumstances for poor people.

Critical evaluation of the ethical dilemma

As per the views of Patrão Neves (2022) in healthcare autonomy is expressed through the rights of adult patient, it associates with undertaking informed-decisions regarding own health and treatment procedure. Thus, it is important to respect the autonomy of patient and accordingly, they should be involved in decision making and further it is important to make patient aware about their health circumstance. On contradictory note Pinho et al, (2022) healthcare rationing impacting the autonomy of patient, they are not involved in decision making and further due to resource allocation procedure service users does not able to receive the services. This is raising a major ethical concern which requires to be focused out.

The principle of beneficence is explicated as the moral obligation that needs to be performed, service provider must act in such way that consider best interest of patient. This principle has not been met in healthcare rationing as patient interest are not considered and healthcare providers guides them in accordance with their own interest rather than determining patient interest (Bognar and Hirose, 2022). Hence, it can be said that healthcare rationing is impacting the satisfaction and interest level of patient and therefore, it is important to consider significant focus on this area.

Justice is at the forefront of healthcare; it signifies that each patient should be treated with equality. It targets the social determinants of health such as; lack of access to healthcare, education, economic instability and so on components. The core focus implied on providing equal and quality treatment to patient. However, healthcare rationing has been incorporated for developing a balanced society where essential resources can be saved and equal distribution can be assured (Aziz, 2023). Nevertheless, loopholes in the system there is unequal distribution of the resources. The refusal to services and issues related to resource scarcity are primarily faced by poor people and furthermore, they are complying with healthcare rationing as well due to which they are not able to receive healthcare services in essential areas. Thus, major complexities are faced by underprivileged section that raises the concerns related to discrimination. The principle of non-maleficence impacts the healthcare decision by prioritising the safety of patient, this principle states that it is important to protect patient from any kind of harm (Patrão Neves, 2022). Healthcare provider should not cause pain or suffering to patient and similarly, in healthcare rationing it is important to detect whether the treatment has any alternate options or not. Then only denial should be undertaken otherwise, it is important to pursue the treatment along with providing necessary resources to patient.

The standards of conduct performance and ethics underpins major ethical standards that are important to be followed in healthcare. Promoting and protecting the interest patient is essential while maintaining their confidentiality. Healthcare rationing is protecting the interest of patient on societal level (The ethical framework, 2023). However, on individual level there are so many individuals who are coping up with this mechanism and as a result, they are not able receive the healthcare services. Another important ethics comprised with maintaining honesty with the patient. For example- if a patient has been denied to undertake treatment, then, it is the accountability of healthcare provider to guide patient about alternative option which can ease the pain and symptom (The ethical framework, 2023). The honesty should be maintained, it is important to consider the individual interest as this ultimately promotes societal goods. Record-keeping should be undertaken at the setting and healthcare providers must maintain the records if they have refused any treatment, proper justification should be provided (The ethical framework, 2023).

Thus, it is important to maintain ethical records for complying with ethical practice and healthcare rationing should not be combined with the basic needs of patient. There is need to implement structured framework that promotes fairness and equality in the process. The healthcare providers decide about the treatment procedure and public is not involved in the rationing decision that signifies about a non-systematic approach (Aziz, 2023). The medical doctors have been given limited budget and resources that are based on clinical priorities due to which service providers denies for treatment in certain areas. For example- doctor refuse to undertake dialysis for patient who are above the age of 55 due to limited budget or resources (Papastavrou et al, 2020). However, this is unethical as the healthcare rights of patient does not provide approval in this context.

Personal Reflection

In my belief, healthcare aligns with prioritising personal health beliefs and ethical domains, there is need to prioritise individual interest. Each person is unique when it comes to resilience power. The healthcare rationing is incorporated with the motive of promoting societal good. However, as a result, individual values are ignored to greater extent, healthcare works on the fundamental of equality but the gaps in the society is acting as a barrier in incorporation of equality. Each person has unique requirement with regards to their health, for example- a person who is suffering from mental health issue might recover through counselling while another person who is at the same stage of mental health requires SSRIs. The resilience power of individuals is different which impacts their well-being (Schubert et al, 2021). Healthcare rationing does not consider these differentiation attributes and implies same decision for all.

However, major concern aligns with the increasing gap among the different groups of society. Healthcare rationing is not impacting richer section as they are able to bear the cost of treatment and therefore by paying extra charges they receive services. On the other hand, poor people are not able to pay expenses and therefore healthcare rationing is mainly implied on them. This is signifying about the discrimination persisting in the society.

I can say that my values will impact my decision-making procedure, I will priorities the ethics and I will always consider the best interest for patient and while adhering with evidence-based practices I am going to take significant decisions. I am going to priorities the patient interest rather than personal interest. This is the core ethical attribute that is required in healthcare settings. On societal level, healthcare rationing is essential I am not denying it but, the major issue is that only certain sections of society are accountable for saving the resources just because they are not financially stable. The allocation should be equal regardless of considering financial stability, it is important to consider the situation and well-being of patient. Therefore, I will focus on undertaking significant actions that adheres with ethics and morals and subsequently, I will priorities the interest of patient and this will lead to support me in taking effectual decision. In this manner, I will be able to perform evidence-based practices in future and patient interest would be my first priority and I will accordingly take decision and health outcomes would be enhanced.

Conclusion

The problem with healthcare rationing is persisting as some section of the society receives more resources while other groups receiving less. Hence, rationing can often lead to resource allocation inefficiencies and therefore, it is important to undertake a systematic approach. The mandatory treatment that are impacting the well-being of individuals should be undertaken and most importantly equality requires to be promoted. There must be equal distribution of the resources so that people from all communities can get access to healthcare resources and services. The societal good is the ultimate agenda of healthcare rationing. However, underprivileged groups are struggling with the disparities and unethical practices and rationing has further developed distressing situation for them. My position is of scholar, my stance on ethical dilemmas with respect to healthcare rationing aligns with taking a more comprehensive approach in which individual interest is needed to be prioritised because only poor people are suffering due to healthcare rationing. 

The unequal distribution of resources and privileged to certain sections in society is creating ethical issues for other groups. Henceforth, patient interest requires to be considered and when the equal resource distribution will be considered then, it ultimately solves the issues regarding scarcity of resources. There is need to limit the excessive use of resources nevertheless, healthcare rationing is impacting the basic requirements of patient which is not justified. There is need to undertake frequent policies in this area as healthcare rationing has increased the distressing situation for individuals who are from lower socio-economic background. Does healthcare rationing adheres with individual requirements? It is an important question which should be focused out, individuals who are not financially stable facing consistent disparities in healthcare sector due to lack of resources and healthcare rationing process.

References

Books and Journals

• ALMesned, S., Alakhfash, A.A., Almesned, F.S. and Almesned, A., 2021. Healthcare rationing and economic evaluation in health care. Journal of Environmental Science and Public Health, 5(4), pp.536-543.
• Aziz, H. and Brandl, F., 2021, July. Efficient, fair, and incentive-compatible healthcare rationing. In Proceedings of the 22nd ACM Conference on Economics and Computation (pp. 103-104).
• Aziz, H., 2023, May. Probabilistic Rationing with Categorized Priorities: Processing Reserves Fairly and Efficiently. In Proceedings of the 2023 International Conference on Autonomous Agents and Multiagent Systems (pp. 949-956).
• Berezowski, J., Czapla, M., Manulik, S. and Ross, C., 2023. Rationing in healthcare—a scoping review. Frontiers in Public Health, 11, p.1160691.
• Bognar, G. and Hirose, I., 2022. The ethics of health care rationing: an introduction. Routledge.
• Bognar, G. and Hirose, I., 2022. The ethics of health care rationing: an introduction. Routledge.
• Brendbekken, A., Robberstad, B. and Norheim, O.F., 2022. Public participation: healthcare rationing in the newspaper media. BMC Health Services Research, 22(1), p.407.
• Eijkholt, M., Broekman, M., Balak, N. and Mathiesen, T., 2021. Three pitfalls of accountable healthcare rationing. Journal of medical ethics, 47(12), pp.e22-e22.
• Hancock, L. and Mackey, P., 2020. Health care funding and rationing health care. In Health policy in the market state (pp. 87-112). Routledge.
• Moosa, M.R. and Luyckx, V.A., 2021. The realities of rationing in health care. Nature Reviews Nephrology, 17(7), pp.435-436.
• Papastavrou, E., Igoumenidis, M. and Lemonidou, C., 2020. Equality as an ethical concept within the context of nursing care rationing. Nursing Philosophy, 21(1), p.e12284.
• Patrão Neves, M.D.C., 2022. Criteria for ethical allocation of scarce healthcare resources: rationing vs. Rationalizing in the treatment for the elderly. Philosophies, 7(6), p.123.
• Patrão Neves, M.D.C., 2022. Criteria for ethical allocation of scarce healthcare resources: rationing vs. Rationalizing in the treatment for the elderly. Philosophies, 7(6), p.123.
• Pinho, M. and Araújo, A.M., 2022. Personality and perceptions about the use of personal responsibility for illness as a health care rationing criteria. Journal of Neuroscience, Psychology, and Economics, 15(3), p.137.
• Robertson, C., 2022. What the harm principle says about vaccination and healthcare rationing. Journal of Law and the Biosciences, 9(1), p.lsac017.
• Schubert, M., Ausserhofer, D., Bragadóttir, H., Rochefort, C.M., Bruyneel, L., Stemmer, R., Andreou, P., Leppée, M., Palese, A. and RANCARE Consortium COST Action–CA 15208, 2021. Interventions to prevent or reduce rationing or missed nursing care: A scoping review. Journal of advanced nursing, 77(2), pp.550-564.

Online

• The ethical framework, 2023. Available through: < https://www.hcpc-uk.org/standards/standards-of-conduct-performance-and-ethics/ >
• UK Legislations, 2022. Online. Available through: < https://www.legislation.gov.uk/ukpga/1998/42/contents >