• Jochanan Benbassat.
• Health Policy Research Program, JDC-Brookdale Institute, Jerusalem.
• Harefuah. 2003 Feb 1; 142 (2): 103-8, 159.

AbstractThe gap between infinite healthcare needs and finite health resources imposes on practicing physicians a dual commitment to patients' needs and to the fair allocation of health care resources. The ethical principles of a fair allocation of resources are egalitarianism, utilitarianism and a transition from individual to group-based ethics. These principles are ambiguous and occasionally conflicting. Their implementation is further impeded by practice norms, such as private practice by physicians employed by public institutions, incentives for physicians to save, and marketing of clinical interventions of unproven efficacy. Proposed approaches to these barriers to the fair allocation of resources include respect of patient autonomy with full disclosure of the limitations in the services provided by the health plan; adherence to clinical practice guidelines; and an open access for patients to second medical opinion. I believe that the fairness of resource allocation may be further improved by the prohibition of private practice by physicians employed in public health care institutions, and by enhancement of physicians' self-awareness of subconscious discrimination against some patients.

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