The ethics of grandfather clauses in healthcare resource allocation
A grandfather clause is a provision whereby an old rule continues to apply to some existing situation while a new rule applies to all future cases. This paper focuses on the use of grandfather clauses in health technology appraisals (HTAs) issued by the National Institute for Health and Care Excelle...
| Главные авторы: | ; ; ; |
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| Формат: | Электронный ресурс Статья |
| Язык: | Английский |
| Проверить наличие: | HBZ Gateway |
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| Fernleihe: | Fernleihe für die Fachinformationsdienste |
| Опубликовано: |
Wiley-Blackwell
[2021]
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| В: |
Bioethics
Год: 2021, Том: 35, Выпуск: 2, Страницы: 151-160 |
| Индексация IxTheo: | KBF Британские острова NCH Медицинская этика NCJ Научная этика |
| Другие ключевые слова: | B
NICE
B grandfather clause B withdrawing and withholding treatment B healthcare resource allocation |
| Online-ссылка: |
Presumably Free Access Volltext (Verlag) Volltext (doi) |
| Итог: | A grandfather clause is a provision whereby an old rule continues to apply to some existing situation while a new rule applies to all future cases. This paper focuses on the use of grandfather clauses in health technology appraisals (HTAs) issued by the National Institute for Health and Care Excellence (NICE) in the United Kingdom. NICE provides evidence-based guidance on healthcare technologies and public health interventions that influence resource allocation decisions in the National Health Service (NHS) and the broader public sector in England and Wales. In this context, a grandfather clause is included when NICE does not recommend treatment with a given technology. The grandfather clause provides an exemption from the general recommendation for patients who have already started treatment with the technology in question, before the publication of the NICE guidance. In this paper we first lay out the contexts in which grandfather clauses occur in NICE guidance, and then consider ethical arguments against and in support of grandfather clauses and the continuation of treatment. We argue that NICE’s current practice of automatic inclusion of a grandfather clause is ethically problematic and unfair. While the inclusion of a grandfather clause may be appropriate and justified in specific cases, we argue that inclusion of such a clause should be considered as part and parcel of the decision making process on a case by case basis, rather than adopted as the default. |
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| ISSN: | 1467-8519 |
| Второстепенные работы: | Enthalten in: Bioethics
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| Persistent identifiers: | DOI: 10.1111/bioe.12815 |