Rationing in Medicine

The book series on the ethics of science and technology assessment edited by the Europ? ische Akademie is devoted to the publication of the work-reports of its project groups, works on the foundations of ethics, the philosophy science, and other issues related to the work of the Europ? ische Akademie. In addition, the series comprises the proceedings of conferences organized by the academy. The 13th volume documents the proceeding of the academy's spring symposium in 2000 on Rationing in Medicine which was held in Bad Neuenahr-Ahrweiler on March 23-25, 2000. An intense discussion on the future of health care in Europe has been stimulated by increasing difficulties of securing adequate and needs orientated medical care in the face of scarce resources and medical progress. Un fortunately, quite of ten a rational discussion of rationing is drowned out by the politic al talk of the day. But only an open and well-informed debate, if anything at ali, can lead to transparent and just rationing procedures which eventually might be acceptable to the public at large. For this debate much can be learnt from observing the experiences other countries have made with their health care arrangements. What kinds of mistakes should be avoided and what might be useful in the different states and perhaps also in the supra-national context of an emerging Europe are interesting and important issues.

I Rationing in international Perspective. - Rationing: Distribution, Limitation, or Denial? Against Conceptual Confusion in the Debate about Health Care Systems. - A Note on the Semantics of Rationing as Limitation. - Prioritizing and Rationing. - The Practice of Rationing Health Care in the United Kingdom. - Comment on Professor David Hunter s Talk. - II Practices of Rationing in Germany. - Rationing in Intensive Care Medicine. - Panel: Global Budgets and Rationing Rationing is inevitable: Modern Medicine as a Victim of its own Success. - Rationing in Medicine: Some Issues in the Light of Economic Theory. - Rationing in Medicine: Cost Containment versus Quality Improvement. - III Rationing, Ethics, and the Law. - The Impact of the German Constitution on Rationing in Medicine. - Rationing Yes, Politics No. For a Right-based Approach in Rationing Medical Goods. - Rationing Basic Philosophical Principles and the Practice. - IV The Future of Rationing. - Complementarity of Private and Public Insurance. - Rationing of Health Care and the Complementarity of Private and Public Insurance. - Summary Thoughts.