Abstract
This article accounts for the failure of the Dutch Government Committee on Choices in Health Care to develop useful criteria of necessary care by which to set health care priorities and ration resources. The Government Committee has been inspired by philosophers who think that allocation problems cannot be solved without placing broad moral questions about the good life, and about the place of health and illness in our lives on the public agenda. The fruitless attempts of the Committee to formulate an effective notion of essential care, based upon a community-oriented perspective of health, shows why the communitarian approach is bound to fail. Questions about essential health care cannot be answered on a macro-level. The only way to get some reasonable control over day-to-day health care allocation decisions in hospitals and institutions is by trying to understand the history, laws, habits and contingencies of what is going on between doctors and patients. Such an understanding can be gained by developing a relational and biographical view on the doctor-patient relationship.
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References
Ministry of Welfare, Health and Cultural Affairs (1992).Choices in Health Care, A Report by the Government Committee on Choices in Health Care, Zoetermeer, The Netherlands, p. 54.
Ministry of Welfare, Health and Cultural Affairs (1992).Choices in Health Care, Zoetermeer, The Netherlands, p. 87.
Callahan, D. (1987).Setting Limits. Medical Goalds in an Ageing Society, New York, and (1990).What Kind of Life? The Limits of Medical Progress, New York.
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van Willengenburg, T. Communitarian illusions: Or why the Dutch proposal for setting priorities in health care must fail. Health Care Anal 1, 49–52 (1993). https://doi.org/10.1007/BF02196970
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DOI: https://doi.org/10.1007/BF02196970