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Africa
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Social value judgements: implementing the Citizens Council reports
Published in Peter Littlejohns, Patients, the Public and Priorities in Healthcare, 2018
There is a powerful human impulse, known as the ‘rule of rescue’, to attempt to help an identifiable person whose life is in danger, no matter how much it costs. When there are limited resources for healthcare, applying the ‘rule of rescue’ may mean that other people will not be able to have the care or treatment they need.
Priority setting, rationing and the consumer role
Published in Penelope Mullen, Peter Spurgeon, Priority Setting and The Public, 2018
Penelope Mullen, Peter Spurgeon
Some argue that ‘society’ must overcome its instincts – its sympathy for the named individual – and proceed with setting priorities to maximise health gain. Welch and Larson (1988, p.173) argue that the ‘unidentified future patients need strong advocates in the medical community’. Others, however, acknowledge the existence of the ‘duty to care’ or the ‘rule of rescue’ and argue that it must be accommodated in any decisions about the allocation of healthcare resources.
Setting the Stage: An Overview of Healthcare
Published in Bill Runciman, Alan Merry, Merrilyn Walton, Safety and Ethics in Healthcare, 2007
Bill Runciman, Alan Merry, Merrilyn Walton
In summary, QALYs provide a tool for use in evaluating the cost-effectiveness of medical treatments in defined groups of patients, but there are limitations to their use. In practice, after extensive community consultation, it has been found that some societies are prepared in principle to spend more on some sorts of diseases and interventions than on others. The state of Oregon in the USA tried to fund its healthcare in this way. Its ranking differed from that predicted by a purely technical approach.49 One reason for this difference was the value placed by the public on life-saving interventions. There is a strong ‘rule of rescue’ phenomenon that seems to be a hallmark of human behaviour.50 This is exemplified by the huge amounts of taxpayers’ money regularly expended on exercises such as rescuing lone yachtsmen or women, who have deliberately taken extreme risks in ocean racing for no greater objective than sporting achievement.
Uterus Transplantation: The Ethics of Using Deceased Versus Living Donors
Published in The American Journal of Bioethics, 2018
Bethany Bruno, Kavita Shah Arora
Deceased organ donation for lifesaving organs is morally based in the principles of rescue ethics. According to the rule of rescue, a moral responsibility exists to save endangered human life whenever possible. Thus, if one can donate organs after death to save other individuals, one has a duty to do so because postmortem organ removal involves no physical risks, costs, or inconvenience to the donor, and the ability to save lives justifies desecration of the deceased’s body (Howard 2006). However, due to the principles of autonomy and respect for persons, organs may only be removed from deceased individuals who gave explicit consent for donation or from individuals whose families have given surrogate consent.
Budget impact analysis: can we afford the added value?
Published in Journal of Medical Economics, 2021
When assessing the affordability of medicines, and specifically for rare diseases, we should bear in mind that in other sectors of public governance, the rule of rescue is invoked10. The rule of rescue entails the need to save individual lives, even in cases that from a merely technical perspective, the money would be more efficiently spent elsewhere. Some authors remonstrate with this approach and contend that on a societal level we are willing to pay a considerable amount of money to rescue sailors and mountaineers from life-threatening situations, albeit in nonessential activities. This mindset conflicts with the reluctancy to reimburse orphan drugs, solely on grounds of costs.