BMJ 1995;311:125 (8 July)

Letters

Rationing is not inevitable

EDITOR,--In the debate about rationing, rationing is often assumed to be inevitable.1 But is it? As Rawles has pointed out: "The ethical problem of how to apportion limited resources amongst the needy has been forced on us by arbitrary limitation of health care expenditure. Its solution would not be required if health expenditure were higher."2

Those who support rationing often say that resources are finite but demands are infinite. Yet this cliche does not bear examination. It is a version of Malthus's discredited argument that populations would always outrun resources. It would be closer to the truth to argue that resources are infinite while demands are finite. Any sensible definition of the resources involved in health care, as in other human activities, must include the skills, education, and professionalism of those working in the sector. There is no limit to these.

Nor are demands infinite. Firstly, any human life is . . . [Full text of this article]


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Relevant Article

Rationing intensive care
J Bion
BMJ 1995 310: 682-683. [Extract] [Full Text]

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