• M Roesgen, E Bertram, S Grafe, H Hermichen, H J Oestern, and E Scola.
• Geschäftsstelle der DGU, Arbeitsgemeinschaft Ethik, Recht, Geschichte der DGU, Straße des 17. Juni 106-108, 10623, Berlin, Deutschland. dr.m.roesgen@gmx.de.
• Unfallchirurg. 2019 Jun 1; 122 (6): 490-494.

AbstractThe development of the healthcare system in Germany is increasingly approaching human and economic limits. A social consensus and a political concept at which point priorities are promoted and for which services the money should be primarily spent, do not exist on the whole. As soon as it becomes clear that resources are limited and that is now, prioritization has to be introduced to avoid the alternative threat of rationing of treatment benefits. The goal of prioritization is to rationally and optimally use the existing but limited resources. Medical progress and the relationship to the demographic development are the variables in the future. The individual care of the patient, patients' needs and dependence on access to treatment are the foundations of ethical actions. They must be at the center of attention for doctors and nurses because, after all they are the patient's advocates in the complex healthcare system. At the same time, unjustified claims for entitlement must be rejected just as a preservation of vested rights. Efficiency and economic considerations in diagnostics and treatment are not mutually exclusive. The physician acts as a mediator between the claims of the patient to be treated, the individual realization and the existing resources in the healthcare system.

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