„Just Caring” – Deliberation on equitable use of scarce resources on terminally ill patients (1 June 2012)

Today, many people are dying at an old age and after long chronic disease. Due to the medical progress it is possible to preserve human life, even under precarious conditions. That is why difficult decisions about further treatment have to be made. In the face of scarcity and finiteness of available resources these decisions bear sensitive issues about distributive justice. Patient-centered care in the end of life is extremely costintensive. If there are extremely expensive treatments available, e.g. in intensive care or in oncology, a competitive situation comes up. This competitive situation causes implicit rationing at the bedside. Which criteria are used in this situation? Which criteria should be considered from a medical, legal, economical and ethical point of view? “What does it mean to be a ‘just’ and ‘caring’ society when we have only limited resources to meet virtually unlimited health care needs” (Leonard M. Fleck)?

Central topics of this workshop, discussed from different scientific views and based on various reports, will be: Where are we confronted with problems today? What could be said about the relationship between autonomy, beneficence and distributive justice? What does dignity in dying mean? Do people at the end of life have a special status and therefore should get all possible treatments? Should costs and cost effectiveness even play a role at the end of life? Should we give preference to younger patients? Could the notion of futility help doctors to make difficult end of life-decisions? What could be said about political legitimation of rationing decisions?

The workshop was initiated by Prof. Dr. Gunnar Duttge (Institute of Criminology, Associate 2011/2012) and PD Dr. Markus Zimmermann-Acklin (Fellow 2011/2012).