Ethics & Decision Making a case of providing RRT in Thailand. Yot Teerawattananon International Health Policy Program Journal club, 17 March 2006. Background. Introduction of universal health insurance (NHS-like system) in 2001
Ethics & Decision Makinga case of providing RRT in Thailand
International Health Policy Program
Journal club, 17 March 2006
Estimated programme output
Saving 9,500 lives each year
Budget impact analysis
Given resource constraints and substantial budget is needed to spend on dialysis programme, is the programme justifiable on ethical and moral grounds?
Lipid lowering drugs e.g. statins reduces the odds of a coronary heart disease event by 30% e.g. reduce risk of cardiac death by 0.000X %
Statins: underused by those who would benefit
More people would benefit from prevention of coronary heart disease!
Rule of rescue
Your turn! What do you support? And why?
Rule of rescue
1. Thomson A. Critical reasoning in ethics: a practical introduction. London: Routledge, 1999.
2. Hope T. Medical ethics: a very short introduction. Oxford: Oxford University Press, 2004.
3. Cookson R, Dolan P. Principles of justice in health care rationing. J Med Ethics 2000;26(5):323-9.
4. Pinkerton SD, Johnson-Masotti AP, Derse A, Layde PM. Ethical issues in cost-effectiveness analysis. Evaluation and Program Planning 2002;25(1):71-83.
5. Pignone M, Phillips C, Mulrow C. Use of lipid lowering drugs for primary prevention of coronary heart disease: meta-analysis of randomised trials 10.1136/bmj.321.7267.983. BMJ 2000;321(7267):983-986.