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December 16, 1988

Rationing Medicine

Author Affiliations

University of Chicago Center for Health Administration Studies

University of Chicago Center for Health Administration Studies

JAMA. 1988;260(23):3516-3517. doi:10.1001/jama.1988.03410230134047

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Physicians have a major stake in the subject of this book: "rationing medicine." As those who pay for medical services, including the government, employers, and the public at large, become increasingly convinced that we are spending too much on medical care, there is more and more talk about the need to "ration medicine." Of course, the physician, as the major care giver in our system, has always been involved in rationing plans. What is changing, as author Robert Blank points out, is the nature of this rationing: Physicians always have made rationing decisions on a case-by-case basis at the bedside or in the hospital administrator's office, but not under government pressure in a systematic institutionalized manner. Their central commitment has been to the patient, not to society, and the current shift toward public allocation is a clear threat to medical ethics. (p 129)

Further compounding the ethical problem for physicians