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ETHICAL DILEMMAS of raising needs versus limited resources

ETHICAL DILEMMAS of raising needs versus limited resources. Manfred Maier. CONTENT. reasons for raising needs aspects of resources ethical dilemmas principles of solutions. LEARNING GOALS. explain same developments which challenge our resources

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ETHICAL DILEMMAS of raising needs versus limited resources

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  1. ETHICAL DILEMMASof raising needs versus limited resources Manfred Maier

  2. CONTENT • reasons for raising needs • aspects of resources • ethical dilemmas • principles of solutions

  3. LEARNING GOALS • explain same developments which challenge our resources • discuss some ethical dilemmas arising from biomedical / social developments

  4. RAISING NEEDS IN HEALTH CARE • demographic developments • increased life expectancy • increased elderly population • increase in chronic diseases • new diseases • increase in multi- morbid patients • new epidemics • reduction in birth rate • increased risks due to leisure time activities

  5. RAISING NEEDS • biomedical developments • technical developments (PET,…) • diagnostic / therapeutic improvements • Increased requirement for resources • new medications • screening – prevention – health promotion • palliative care • guidelines • quality improvement measures • information technology • individualized treatment (pharmacogenomics)

  6. LIMITED RESOURCES • financial resources • reimbursement system • structural resources • Health insurance, HC- systems, group practices, facilities • personnel resources • imbalance of health care professionals, generalists - specialists, health care teams • not all goals can be reached at the same time

  7. ECONOMIC RESOURCES • Education Health Care Environment Safety • Prevention Curative Medicine Rehabilitation nursing continued payment of wages • accidents diagnostics medical inpatient sickness • immunization therapy social advising handicapped • health checks emergency care occupational psychosocial • Patient – oriented health care

  8. ETHICAL PRINCIPLES • Primacy of patient welfare • Patient autonomy • Social justice Hippocrates (460-380 bc)

  9. ETHICAL DILEMMAS • demanding patients • patients in need • guideline requirements • genetic diagnostics • screening procedures – prevention – medicalization • palliative care • defensive medicine • to many duties in GP /FM – time limited • public health care – private insurance • economic forces – ethical principles • overuse – misuse – underuse of resources • inpatient – outpatient interface

  10. SOLUTIONS • setting of goals for health care • setting priorities • provision of health care where it is most efficient • communication with the public and with the patient • transparency in health care

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