Rationing resources while improving quality

Robert L. Wears*

*Corresponding author for this work

Research output: Contribution to journalLetterpeer-review


The description by Dr Eddy of how we might "help patients understand the consequences of a limited resource pool and the need to be fair" conflicts with the idea of informed consent and full patient participation in decision making. This conflict needs to be addressed explicitly if we are to make any headway in reducing the rate of increase in costs. Eddy suggests that as physicians guide patients toward accepting collectively better but individually worse options that “in most cases there will be no need to say anything at all. In other cases the explanation might be, 'Well, for patients like you the appropriate approach is….” While many (including me) agree with Eddy's position that it is not unethical to weigh economic costs against health benefit, his recommendation that physicians should simply fail to mention the existence of a therapeutic alternative (offering greater benefit but.

Original languageEnglish
Pages (from-to)995-996
Number of pages2
JournalJournal of the American Medical Association
Issue number13
Publication statusPublished - 5 Apr 1995
Externally publishedYes


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