Abstract
In this chapter, we discuss the situation in countries with a national healthcare system and do not cover countries with private healthcare insurance or those where services are paid out of pocket. Very few countries can meet all the costs of modern medicine for all their citizens. The three consequences of the gap between the available resources and the costs of modern medicine are limited access to costly medical interventions, waiting times for diagnostic and therapeutic interventions, and list of priorities. From the ethical standpoint, it is essential that all three of these issues are openly discussed and agreed within a wide circle including medical professionals and representatives of the lay community. In case of lack of democratic agreement and of clear rules, access to medical care may depend on the social and/or economic position of an individual. In a society based on solidarity, such a situation is contrary to the ethical principle of justice and may be considered to be a form of corruption.
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Notes
- 1.
Originator (also original) drugs are those that have been granted marketing authorization on the basis of studies done by the manufacturer that prove the drug’s safety, quality, and efficacy. Once the originator drug loses patent protection, another manufacturer can make and market a generic drug with the same active substance. Generic drugs are typically not tested in additional clinical studies and can be significantly cheaper.
- 2.
In Slovenia, the physician can indicate one of the four levels of urgency when referring a patient to a specialist: urgent, very fast, fast, or regular.
- 3.
In the drug information leaflet, the manufacturer writes: “We currently do not have sufficient data based on which we could recommend the use of Remifentanil during labor or Caesarean section. Remifentanil is transported through the placental membrane; analogues of Remifentanil can cause respiratory depression in newborns.” English anesthesiologist Prof. Felicity Reynolds Spencer, a leading expert, wrote that Remifentanil is “worse than useless” for managing labor pain and in many respects harmful to the newborn (personal communication, January 2, 2016).
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Zwitter, M. (2019). Limited Resources, Priorities, and Corruption. In: Medical Ethics in Clinical Practice. Springer, Cham. https://doi.org/10.1007/978-3-030-00719-5_10
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DOI: https://doi.org/10.1007/978-3-030-00719-5_10
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