Letters

Ethics of rationing health care services

BMJ 1995; 310 doi: http://dx.doi.org/10.1136/bmj.310.6974.261c (Published 28 January 1995) Cite this as: BMJ 1995;310:261
  1. Dennis Cox
  1. General practitioner, Bluntisham, Cambridgeshire PE17 3LT

    EDITOR,—Unlike Raanon Gillon,1 I find myself agreeing with the King's Fund when it advocates the formation of a Oregon-like commission modelled on the Nuffield Council of Bioethics to start the process of rationing of specific services.2

    Gillon doubts whether it is morally safe to use, as he sees it, “populist solutions in distributive justice such as have occurred in Oregon … and technical and simplistic economic solutions such as the system of costed quality adjusted life years (QALYs).”1 Instead he favours seeking ways of “muddling through elegantly” as advocated by Hunter in Rationing Dilemmas in Health Care.3 Gillon is offended by …

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