Home 
Contact 
Profile 
Videos 
Presentation at a training program ‘Applying
the Principles of Ethics to Clinical Practice:’ held at Aramco Dhahran
April 6, 2015 by Professor Omar Hasan Kasule Sr. MB ChB (MUK). MPH (Harvard),
DrPH (Harvard) Chairman of the Ethics Committee King Fahad Medical City.
Basis
for resource allocation (by Ghaiath MA Hussein PEER SCHS 2014)
·
CEA: (Effectiveness) - -
priority given to those most likely to achieve a good outcome, i.e. Medical Success
·
Medical
Need - - priority given to those most in need of medical
intervention or those considered most helpless or generally neediest in society
– vulnerable groups
·
Utility - -
achieving the least morbidity/mortality possible given the resources available
(maximizing good health/survival with the available resources)
·
Immediate
Usefulness - - priority given to those with special skills that could
be used to serve the common good in the immediate circumstance
·
General
Social Value - - priority given to those who are considered by society to
have the greatest social worth (past or future)
·
Principle of Conservation - -
priority given to those who use proportionally less resources
·
Responsibility
for Dependents - - priority given to those who have primary
responsibilities to dependents (parents, nursing home attendants, etc.)
·
None if
not all - - no one should be saved if not all can be saved
·
Queue - -
priority given on a first-come, first-served basis
·
Random
Selection - - allocation determined by chance (a lottery, for example)
·
Ability to
Pay - - priority given to those who can pay for the resources
·
Merit
based - - priority given to those who have earned it due to past
actions
Case scenario 1
Scenario: A 90-year old with
multi organ failure and clinical signs of brain stem death on life support was
occupying the last available bed in the ICU because the doctors were afraid to
disclose death to the family that had many vocal and angry members. However
when 50 survivors from an air crash site were brought it, the doctors decided to
withdraw life support from the old man to free up at least one ICU bed.
Case scenario 2
A
patient presented to the clinic with vague complaints in the abdomen and
worries about cancer. Physical examination and investigations revealed no
pathology. The doctor was angry with the
patient for wasting clinic time when he was in good health. As the patient was leaving he told the doctor
that his uncle had died the week before of stomach cancer. The doctor did not
respond. What should the doctor have done? Provide your moral reasoning.