Rationing: Theory, Politics, and Passions

Daniel Callahan

in The Roots of Bioethics

Published in print October 2012 | ISBN: 9780199931378
Published online January 2013 | e-ISBN: 9780199980598 | DOI:
Rationing: Theory, Politics, and Passions

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Sarah Palin, introducing the phrase “death panels” during the healthcare reform debate, injected a particularly sour flavor into the already troubled discussion of the control of healthcare costs. The field of bioethics had started in 1960 with a shortage of dialysis machines and a committee in Seattle whose task it was to select those who would live and die. One could indeed call that a “death panel.” Moreover, a number of bioethicists in recent years have openly argued that rationing would be needed to control healthcare costs and that some kind of committee would be needed to establish the criteria for doing so. Yet, although those discussions have gone on, it also became clear that, in part because of Palin, rationing is a word that cannot be used in the political arena, thus precluding a serious public discussion. Three forms of rationing are described: (1) overt rationing, (2) indirect rationing, and (3) covert rationing. The latter two are now far more likely than the former, but a way must be found to have an open discussion and fair, clear ways of actually doing so; otherwise, covert rationing becomes a real possibility.

Keywords: rationing; politics; passion; Palin; accountability

Chapter.  4055 words. 

Subjects: Moral Philosophy

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