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Anesthesiology Research and Practice
Volume 2009, Article ID 915197, 8 pages
http://dx.doi.org/10.1155/2009/915197
Review Article

The Ethics of Rationing of Critical Care Services: Should Technology Assessment Play a Role?

Department of Anesthesiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA

Received 27 May 2009; Revised 13 July 2009; Accepted 2 September 2009

Academic Editor: Alex Macario

Copyright © 2009 Eric L. Bloomfield. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Linked References

  1. N. Adhikari and W. Sibbald, “The large cost of critical care: realities and challenges,” Anesthesia & Analgesia, vol. 96, no. 2, pp. 311–314, 2003. View at Publisher · View at Google Scholar · View at Scopus
  2. C. Marsden, “An ethical assessment of intensive care,” International Journal of Technology Assessment in Health Care, vol. 8, no. 3, pp. 408–418, 1992. View at Google Scholar · View at Scopus
  3. D. A. Kindig, Purchasing Population Health: Paying for Results, University of Michigan Press, Ann Arbor, Mich, USA, 1997.
  4. K. J. Arrow, “Uncertainty and the welfare economics of medical care,” American Economic Association, vol. 53, no. 5, pp. 941–973, 1963. View at Google Scholar
  5. J. P. Newhouse, Free for All? Lessons from the RAND Health Insurance Experiment, Harvard University Press, Cambridge, Mass, USA, 1993.
  6. C. DaNavas-Walt, B. D. Proctor, and J. Smith, Income, Poverty and Health Insurance Coverage in the United States, Bureau of the Census, Washington, DC, USA, 2007.
  7. E. L. Bloomfield, “The impact of economics on changing medical technology with reference to critical care medicine in the United States,” Anesthesia & Analgesia, vol. 96, no. 2, pp. 418–425, 2003. View at Publisher · View at Google Scholar · View at Scopus
  8. S. Folland, A. C. Goodman, and M. Stano, The Economics of Health and Health Care, Prentice-Hall, Upper Saddle River, NJ, USA, 2nd edition, 1997.
  9. B. A. Weisbrod, “The health care quadrilemma: an essay on technological change, insurance, quality of care, and cost containment,” Journal of Economic Literature, vol. 29, no. 2, pp. 523–552, 1991. View at Google Scholar
  10. AMA, “New AMA and microsoft collaboration to enhance patient-physician communication,” American Medical Association, Chicago, Ill, USA, July 2009, http://www.ama-assn.org/ama/pub/news/news/ama-microsoft-collaboration.shtml.
  11. A. J. Moss, W. Zareba, W. J. Hall et al., “Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction,” The New England Journal of Medicine, vol. 346, no. 12, pp. 877–883, 2002. View at Publisher · View at Google Scholar · View at Scopus
  12. G. D. Sanders, M. A. Hlatky, and D. K. Owens, “Cost-effectiveness of implantable cardioverter-defibrillators,” The New England Journal of Medicine, vol. 353, no. 14, pp. 1471–1480, 2005. View at Google Scholar
  13. H. C. Sox, M. A. Blatt, M. C. Higgins, and K. I. Marton, Medical Decision Making, American College of Physicians, Philadelphia, Pa, USA, 2007.
  14. A. A. Scitovsky, “Changes in the costs of treatment of selected illnesses, 1971–1981,” Medical Care, vol. 23, no. 12, pp. 1345–1357, 1985, erratum in: Medical Care, vol. 25, no. 1, p. 86, 1987. View at Google Scholar
  15. R. W. Fogel and D. L. Costa, “A theory of technophysio evolution, with some implications for forecasting population, health care costs, and pension costs,” Demography, vol. 34, no. 1, pp. 49–66, 1997, erratum in: Demography, vol. 34, no. 2, p. 170, 1997. View at Google Scholar · View at Scopus
  16. N. A. Halpern and S. M. Pastores, “Technology introduction in critical care: just knowing the price is not enough!,” Chest, vol. 116, no. 4, pp. 1092–1099, 1999. View at Publisher · View at Google Scholar · View at Scopus
  17. S. Streat and J. A. Judson, “Cost containment: the Pacific. New Zealand,” New Horizons, vol. 2, no. 3, pp. 392–403, 1994. View at Google Scholar · View at Scopus
  18. L. Dragsted and J. Qvist, “Epidemiology of intensive care,” International Journal of Technology Assessment in Health Care, vol. 8, no. 3, pp. 395–407, 1992. View at Google Scholar · View at Scopus
  19. B. Gipe, “Financing critical care medicine in 2010,” Cost & Quality, vol. 5, no. 4, pp. 14–26, 1999. View at Google Scholar · View at Scopus
  20. C. W. Hanson III, C. S. Deutschman, H. L. Anderson III et al., “Effects of an organized critical care service on outcomes and resource utilization: a cohort study,” Critical Care Medicine, vol. 27, no. 2, pp. 270–274, 1999. View at Google Scholar · View at Scopus
  21. mftrou.com: Management for the rest of us, “W. Edwards Deming: total quality management & Deming's 14 points,” April 2009, http://www.mftrou.com/edwards-deming.html.
  22. Ontario Intensive Care Study Group, “Evaluation of right heart catheterization in critically ill patients,” Critical Care Medicine, vol. 20, no. 7, pp. 928–933, 1992. View at Google Scholar
  23. K. Chatterjee, “The Swan-Ganz catheters: past, present, and future: a viewpoint,” Circulation, vol. 119, no. 1, pp. 147–152, 2009, erratum in: Circulation, vol. 119, no. 21, p. e548, 2009. View at Publisher · View at Google Scholar · View at Scopus
  24. Coalition for Critical Care Excellence: Consensus Conference on Physiologic Monitoring Devices, “Standards of evidence for the safety and effectiveness of critical care monitoring devices and related interventions,” Critical Care Medicine, vol. 23, no. 10, pp. 1756–1763, 1995. View at Publisher · View at Google Scholar · View at Scopus
  25. M. Jastremski, C. Jastremski, M. Shepherd et al., “A model for technology assessment as applied to closed loop infusion systems. Technology Assessment Task Force of the Society of Critical Care Medicine,” Critical Care Medicine, vol. 23, no. 10, pp. 1745–1755, 1995. View at Google Scholar · View at Scopus
  26. W. B. Schwartz, “In the pipeline: a wave of valuable medical technology,” Health Affairs, vol. 13, no. 3, pp. 70–79, 1994. View at Publisher · View at Google Scholar · View at Scopus
  27. W. J. Sibbald, J. A. Eberhard, K. J. Inman, and C. L. Sprung, “New technologies, critical care, and economic realities,” Critical Care Medicine, vol. 21, no. 11, pp. 1777–1780, 1993. View at Google Scholar · View at Scopus
  28. R. G. Hauser and A. K. Almquist, “Learning from our mistakes? Testing new ICD techology,” The New England Journal of Medicine, vol. 359, no. 24, pp. 2517–2519, 2008. View at Google Scholar
  29. T. L. Beauchamp and J. F. Childress, Principles of Biomedical Ethics, Oxford University Press, New York, NY, USA, 4th edition, 1994.
  30. The Leapfrog Group, The Leapfrog Group, Washington, DC, USA, April 2009, http://www.leapfroggroup.org.
  31. Wikipedia, the Free Encyclopedia, “Cardiopulmonary resuscitation: history,” April 2009, http://en.wikipedia.org/wiki/Cardiopulmonary_resuscitation#History.
  32. J. E. Zimmerman, D. P. Wagner, W. A. Knaus, J. F. Williams, D. Kolakowski, and E. A. Draper, “The use of risk predictions to identify candidates for intermediate care units: implications for intensive care utilization and cost,” Chest, vol. 108, no. 2, pp. 490–499, 1995. View at Google Scholar · View at Scopus
  33. J. M. Luce, “Physicians do not have a responsibility to provide futile or unreasonable care if a patient or family insists,” Critical Care Medicine, vol. 23, no. 4, pp. 760–766, 1995. View at Google Scholar · View at Scopus
  34. Wikipedia, the Free Encyclopedia, “Terri Schiavo case,” February 2009, http://en.wikipedia.org/wiki/Terri_Schiavo.
  35. M. H. Waymack, “Daniels on justice and healthcare: laudable goals—questionable method,” The American Journal of Bioethics, vol. 1, no. 2, p. 28, 2001. View at Google Scholar · View at Scopus
  36. Brainy Quote, BrainyMedia, Definition of ration, April 2009, http://www.brainyquote.com.
  37. G. Jurasek, “Rationing care in the ICU—everybody does it,” PulmonaryReviews.com, vol. 10, no. 3, 2005. View at Google Scholar
  38. M. M. Levy, “Rationing in the ICU,” in Proceedings of the Society of Critical Care Medicine: 34th Critical Care Congress, Phoenix, Ariz, USA, January 2005.
  39. The Society of Critical Care Medicine Ethics Committee, “Attitudes of critical care medicine professionals concerning distribution of intensive care resources,” Critical Care Medicine, vol. 22, no. 2, pp. 358–362, 1994. View at Google Scholar · View at Scopus
  40. W. A. Knaus, “APACHE 1978–2001: the development of a quality assurance system based on prognosis: milestones and personal reflections,” Archives of Surgery, vol. 137, no. 1, pp. 37–41, 2002. View at Google Scholar · View at Scopus
  41. D. J. Cook and M. Giacomini, “The sound of silence: rationing resources for critically ill patients,” Critical Care, vol. 3, no. 1, pp. R1–R3, 1999. View at Publisher · View at Google Scholar · View at Scopus
  42. J. M. Luce and G. D. Rubenfeld, “Can health care costs be reduced by limiting intensive care at the end of life?” American Journal of Respiratory and Critical Care Medicine, vol. 165, no. 6, pp. 750–754, 2002. View at Google Scholar · View at Scopus
  43. R. M. Califf and L. H. Muhlbaier, “Health insurance portability and accountability act (HIPAA): must there be a trade-off between privacy and quality of health care, or can we advance both?” Circulation, vol. 108, no. 8, pp. 915–918, 2003. View at Publisher · View at Google Scholar · View at Scopus
  44. J. Oberlander, T. Marmor, and L. Jacobs, “Rationing medical care: rhetoric and reality in the oregon health plan,” Canadian Medical Association Journal, vol. 164, no. 11, pp. 1583–1587, 2001. View at Google Scholar · View at Scopus
  45. D. M. Eddy, “Oregon's methods: did cost-effectiveness analysis fail?” The Journal of the American Medical Association, vol. 266, no. 15, pp. 2135–2141, 1991. View at Publisher · View at Google Scholar · View at Scopus
  46. D. W. Bates and A. A. Gawande, “Improving safety with information technology,” The New England Journal of Medicine, vol. 348, no. 25, pp. 2526–2534, 2003. View at Google Scholar
  47. K. W. Goodman, “Bioethics and health informatics: an introduction,” in Ethics, Computing, and Medicine: Informatics and the Transformation of Health Care, K. W. Goodman, Ed., pp. 1–31, Cambridge University Press, Cambridge, UK, 1998. View at Google Scholar
  48. P. Jacobs and T. W. Noseworthy, “National estimates of intensive care utilization and costs: Canada and the United States,” Critical Care Medicine, vol. 18, no. 11, pp. 1282–1286, 1990. View at Google Scholar · View at Scopus
  49. B. Kaplan, “Ethics and EHRs: experts weigh in on the top 10 areas to watch,” Electronic Health Records Briefing, vol. 3, no. 8, pp. 1–3, 2007. View at Google Scholar
  50. W. J. Sibbald, “Introduction: theme articles on technology assessment in critical care,” Journal of Critical Care, vol. 18, no. 1, pp. 38–40, 2003. View at Publisher · View at Google Scholar · View at Scopus
  51. A. K. Jha, C. M. Desroches, E. G. Campbell et al., “Use of electronic health records in U.S. hospitals,” The New England Journal of Medicine, vol. 360, no. 16, pp. 1628–1638, 2009. View at Publisher · View at Google Scholar · View at Scopus
  52. T. Sinuff and D. J. Cook, “Health technology assessment in the ICU: noninvasive positive pressure ventilation for acute respiratory failure,” Journal of Critical Care, vol. 18, no. 1, pp. 59–67, 2003. View at Publisher · View at Google Scholar · View at Scopus