Facility Develops Policy to Fairly Allocate Medications during Critical Shortages

With the number of critical medication shortages in the United States reaching an unprecedented level, physicians, pharmacists, and hospitals must determine an ethically justifiable way to allocate drugs fairly, state the authors of an article published in the October 22, 2012, Archives of Internal Medicine. The article describes the implementation of a comprehensive and ethically defensible policy to oversee allocation of scarce drugs that is based on a hierarchy of clinical need and predicted efficacy, has the virtue of transparency, and conforms to the standards of procedural justice. According to the authors, the limit-setting policy was based on four primary ethical benchmarks: transparency or publicity (the development, rules, and implementation of the policy should be open to all for review), relevance (the policy and the reasons supporting it must be judged clinically relevant to the population of patients and healthcare providers affected by its application, and those reasons should be rationally acceptable by others), appeals (a method for people to appeal a decision that they feel is wrong must be built in), and enforcement (the institution that “owns” the policy must guarantee its implementation such that the rules will be followed by all).