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John Glasson, MD; David Orentlicher, MD, JD
Secretary Council on Ethical and Judicial Affairs American Medical Association Chicago, Ill

Arch Intern Med. 1995;155(18):2017.

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In reply

Weinrauch makes some important observations about the allocation of scarce resources. Using limited resources where they will provide the most benefit is a fundamental social goal. However, his concerns about the Council report reflect either misunderstandings about the report or a failure by him to give due weight to important social values other than maximizing overall benefit.

First, Weinrauch takes some of the Council's guidelines out of the context of the full report and draws inappropriate conclusions as a result. As he observes, the Council rejects, as a criterion for allocation, the patient's contribution to disease. The Council noted that the patient's contribution to disease is often not voluntary, that it is difficult to determine how much the patient's need for treatment really can be traced to the patient's past behaviors, and that only certain deleterious behaviors are singled out for consideration.^1(pp32,33) However, it does not follow, . . . [Full Text PDF of this Article]

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