I found the article, "Administrative Ethics and the Allocation of Scarce Resources", to be very insightful. I agree with Maddox whole-heartedly that health care has to control costs. According to Abbey (1997) in "Health Care Reform: The Road Lies with Managed Care", fully one-seventh of the nation's economy is invested in health care and this amount is expected to increase. The goals of cost containment and increased quality of care often have an inverse relationship; therefore, it is difficult to manage both at the same time. Part of the dilemma is how to allocate the necessarily limited resources in an ethical manner. A consistent, ethical, and flexible decision model needs to be developed. The ethical principles Maddox has outlined in this article are, I believe, the first step of many steps necessary in devising a model for making decisions abut resource allocation.
Michael P. Austin
University of Texas at Austin
School of Nursing
Abbey, F.B. (1997). Health care reform: The road lies with managed care. In P.T. Kongstvedt (Ed.), Essentials of managed health care (pp. 17-35). Gaithersburg, Aspen.