Medizin: „Welcher Patient geht leer aus?“ - News - FOCUS Online
Medicine "Which patient gets nothing?"
Transplant surgeon Eckhard Nagel of the National Ethics Council explains the pressure to ration of medical care
FOCUS: German health politicians will assert that full coverage of the population would remain with cutting-edge medicine. In contrast, the National Ethics Council now proposes a new public debate about rationing. Is this really necessary?
Nagel: Claiming anyone at any time can acquire high-performance medical treatment possible, I think, is a dangerous suppression of reality. Rationing is commonplace in medicine and will increase in future. Even today patients waiting for major operations, such as not enough places for their intensive care available must also be decide in transplantation medicine, which patient receives a saving organ and which no seats and possibly die on the waiting list. This dilemma is seen but not enough.
FOCUS: Why has so far been no public discussion about rationing?
Nagel:
The allocation of limited health goods due to cost is a very sensitive issue to which our society is ill prepared. Politicians have made the experience that they prefer to conceal this uncomfortable truth. Otherwise they run the risk of being punished as a bearer of bad news - for example at the ballot box. Nevertheless, I believe it is their duty to clarify the problem, even if there is no easy exit strategy.
FOCUS: Can we avoid the limited allocation, as we raise more money for the health care system?
Nagel: At the moment already. But medical progress has no foreseeable limits. We are always faced with the question of what we can afford yet.
Is it even possible, as previously granted to all health goods in accordance with the principle of equality? Or treatment should depend on the purse of the patient, his age or his social embeddedness? Must pay an injured person's treatment out of pocket when he caused the accident itself? Such scenarios must be addressed, and that takes an ethical debate.
FOCUS: Must 85-year-old's fear that they will not receive artificial hip or heart valve?
Nagel: I think not. But of course, remain ethical dilemma decisions when conflicts are not enough. We just have to try to the best of all strategies. This decision process has to be transparent. The only way people get the feeling that they are taken into consideration, even if they do not approve of this.
FOCUS: What do you fear, when politicians and citizens continue to ignore that rationing is necessary?
Nagel: This can be fatal, under which the patients - and all of us - eventually suffer unnecessarily. As will be discussed today about the cost of health only in the short term and with hot button words, emotionalizes the situation. This is an unfortunate way to kick start the discussion, because it causes anxiety. Citizens feel existentially delivered.
MEDICAL ETHICS AND
Eckhard Nagel, 46, health scientist at the University of Bayreuth.