P.J. Maddox's article, Administrative Ethics and The Allocation of Scarce Resources, was indeed a revelation for me. I am a staff nurse in a Veterans Administration Hospital in Texas. It is my belief that all nurses are aware of the financial constraints placed on our practice by the ever-changing health care system in this country. We are all familiar with 'do more with less'. The problem is that the "less" is getting less and less every day. As resources continue to decrease, how do we balance what we should do with what we have to do?
This article provides an excellent correlation between ethical issues and the scarcity of resources. Ethical principles were the foundation of our decision to become nurses in the first place. We wanted to 'do good', to help others, and to be just. As resources decrease, and we must do more with less, we must also be ethical in our endeavors. When resources are scarce, how are decisions made? Who decides which clients receive care? Where do nurses fit in the scheme of things? How can we continue to be the advocate for our clients?
Maddox provides an excellent example of the ethical dilemmas facing nursing today, both on a managerial level, and on a staff nurse level. Scarcity of resources does affect nursing at all levels of practice. Reconciling resources and ethical dilemmas is, and will continue to be a challenge.
Nursing must continue to develop interventions that will allow providing quality care, while maintaining acceptable financial limits. The work must continue, and this article was an excellent beginning for me, and hopefully for many others.
Jennifer Randolph, BSN, RN
Graduate Student, Nursing Systems
University of Texas at Austin, School of Nursing
Waco, Texas 76707