Justice and Rationing in the NHS Flashcards Preview

HES > Justice and Rationing in the NHS > Flashcards

Flashcards in Justice and Rationing in the NHS Deck (19)
Loading flashcards...
1
Q

On which date was the NHS founded?

A

July 5 1948.

2
Q

On which principle relating to justice and rationing was the NHS founded?

A

That good health care should be available to all according to need and regardless of wealth.

3
Q

List 2 of the 10 core principles of the NHS plan of 200 that relate to justice and rationing.

A

1 - Universal - care is given on the basis of clinical need rather than ability to pay.

2 - Comprehensive - provide clinically appropriate, cost-effective services.

4
Q

Describe the 2007 case of limiting treatments for Alzheimer’s disease.

A
  • NICE issued a recommendation to provide only limited coverage on the NHS of drugs to treat Alzheimer’s disease.
  • It was argued that this was a breach of the disability and discrimination act and the race relations act.
  • Others argued that some of the drugs that were recommended against were ineffective, such as donepezil.
5
Q

List the 4 pillars of medical ethics.

A

1 - Respect for autonomy - self determination and informed consent.

2 - Beneficence - the patient’s welfare comes first.

3 - Non-maleficence - Do no harm.

4 - Justice.

6
Q

Define justice.

A

Behaviour or treatment that is morally right and fair and equal.

7
Q

Define rationing.

A

The equitable distribution of limited resources.

8
Q

List 3 causes of pressures on rationing.

A

Shifts in:

1 - Demography.

2 - Pattern of disease.

3 - Medical technology.

9
Q

List 4 distributive justice philosophies.

A

1 - According to what is deserved.

2 - According to fairness.

3 - According to needs.

4 - Maximising utility.

10
Q

List 2 possible problems with a utilitarian approach to distributive justice.

A

1 - Trivial diseases outweighing serious ones.

2 - Ultra-orphan (very rare) diseases not prioritised as there may only be expensive treatments.

11
Q

What is section 1 of the NHS act of 2006?

A

The Secretary of State must continue the promotion in England of a comprehensive health service designed to secure improvement in:

1 - The physical and mental health of the people.

2 - The prevention, diagnosis and treatment of illness.

12
Q

What, relating to justice, is made unlawful by the Human Rights act of 1998?

A

For a public authority to act incompatibly with the European Convention on Human Rights:

1 - Prohibition against discrimination.

2 - Prohibition against inhuman or degrading treatment.

3 - Right to life.

4 - Right to privacy.

5 - Right to found a family.

13
Q

What is prohibited by the equality act of 2010?

A

The discrimination against people according to protected characteristics:

1 - Gender reassignment.

2 - Pregnancy.

3 - Race.

4 - Religion / belief.

5 - Sex.

6 - Sexual orientation.

7 - Age.

14
Q

What obligation is given to the secretary of state by the Health and Social Care Act of 2015?

A

The obligation of no avoidable harm to service users.

15
Q

List 6 ways by which the NHS rations healthcare in England.

A

1 - A three year budget is determined in parliament.

2 - The department of health allocates most of the budget to NHS England.

3 - NHS England allocates 75% of the budget to clinical commissioning groups.

4 - NSH England and clinical commissioning groups allocate the budget to GPs and trusts.

5 - Trusts and GPs allocate the budget to specialities, treatments and patients.

6 - Doctors tailor the treatment to patients.

16
Q

What is the purpose of NICE?

A

To provide national guidance on the promotion of good health and the prevention and treatment of ill health.

17
Q

List 5 special considerations that might be taken into account when recommending costly treatments.

A

1 - Severity of the disease.

2 - Disadvantaged populations.

3 - Children.

4 - End of life timespan.

5 - Significant innovation.

18
Q

List 3 arguments against the NHS using Pemetrexed for mesotheliomas.

A

1 - Clinical evidence is limited to one trial.

2 - It is more toxic than other possible medications.

3 - All analyses showed pemetrexed to be not cost effective.

19
Q

List 6 arguments for the NHS using pemetrexed for mesotheliomas.

A

1 - It is an innovative drug.

2 - Used elsewhere in Europe and the USA.

3 - Mesotheliomas are rare diseases.

4 - It is currently the peak of a time-limited disease (as mesotheliomas are linked to asbestos exposure).

5 - It is often disadvantaged patients that suffer from mesotheliomas (due to the nature of the cause).

6 - There is societal responsibility for an industrial disease.