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June 1971

Legal Problems in Allocation of Scarce Medical Resources: The Artificial Kidney

Author Affiliations

Los Angeles

From the School of Law, University of California, Los Angeles (Mr. Dukeminier) and the Divisions of Psychiatry, Cedars-Sinai Medical Center (Dr. Sanders), Los Angeles.

Arch Intern Med. 1971;127(6):1133-1137. doi:10.1001/archinte.1971.00310180149021

Medical science today is creating and allocating resources of immeasurable value. Typical of these is the artificial kidney. Use of the machine means a chance for life; denial means death. Traditionally in our society, when great power over resources is wielded, the law becomes concerned about who exercises that power, by what procedures, for what objectives. Up to the present era, physicians have decided whom to treat, with practically no intervention by the law. But with the changing structure of medical services,1 there seems little possibility of preserving what Dr. Cabot once called the "old tradition of aristocratic, benevolent autocracy in medicine."2 When the delivery of medical services is financed in large part by government funds, the law will inevitably have to look into the system to see whether scarce medical resources are allocated fairly. If history is any guide, the problem of allocating scarce medical resources,

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