Ethical issues arising from variation in health services utilization at the end of life

Front Health Serv Manage. 2011 Spring;27(3):17-26.


Research on health services delivery, particularly at the end of life, has demonstrated that more care does not necessarily lead to better technical quality, patient satisfaction, or outcomes. These findings raise three ethical issues: (1) justice in the allocation of scarce resources across health service areas; (2) nonmaleficence in the provision of appropriate amounts of care to patients; and (3) transparency about local healthcare practice so patients can make enlightened decisions about healthcare choices. We conclude that in this era of healthcare accountability, managers and clinicians can use these ethical principles to drive change in the process of providing more efficient, more effective, and more patient-centered care, especially at the end of life.

MeSH terms

  • Beneficence
  • Decision Making
  • Health Resources
  • Health Services Research
  • Humans
  • Informed Consent
  • Medicare
  • Palliative Care / economics
  • Palliative Care / ethics
  • Palliative Care / statistics & numerical data
  • Terminal Care / economics*
  • Terminal Care / ethics*
  • Terminal Care / statistics & numerical data*
  • United States