Research Project
Ethical Considerations on Health Care Rationing

In the face of the scarcity of resources in health care one has to wonder how both adequate and socially financed health care can be provided for all people in the long run. This is the key problem in the current rationing debates in a lot of high-income countries around the world. Scarcity is very likely to increase due to both demographic changes and the shortage of manpower over the next years. In the context of ethical debates, it has to be discussed how to grant just (concerning rights, duties and claims) and human (with regard to the concepts of a good or flourishing life) access to health care. Health care and support are central issues in Christian social ethics. Within the scope of normative issues human dignity, solidarity, and vulnerability are important principles; relevant issues regarding Christian anthropology concern aspects of Christian identity. Furthermore, the experience of scarcity and limitation provides the opportunity to raise questions about the meaning of limits in life in a deeper sense of the term, both about finiteness of human life and about questionable goals of unlimited medical progress – »False Hopes«, to quote a book title from the American philosopher and founder of the Hastings Center Daniel Callahan.

For several years I’ve been doing research in health care ethics, participating in public debates and publishing several papers. During my research stay at the Lichtenberg-Kolleg, I would like to proceed with a monograph on health care rationing, structured in five parts: (1) Description of the problem, (2) clarification of terms, (3) experiences made with health care rationing, (4) ethical discussion, (5) recommendations. The goal of my project is to gain systematic knowledge useful to guiding decisions and practices of responsible people involved in health care decisions on different levels, be it in politics, in management or at the bedside.

Selected Publications

Zimmermann-Acklin, M. 2011 (forthcoming). «Altersrationierung und Gerechtigkeit im Gesundheitswesen» in Schicktanz, S. / Schweda, M. (eds.): Pro-Age oder Anti-Aging? Altern im Fokus der modernen Medizin. Frankfurt a. M.: Campus.

Zimmermann-Acklin, M. 2011. «Die Rationierungsdiskussion in der Schweiz. Beobachtungen aus ethischer Perspektive» in Wild, V. / Pfister, E. / Biller-Andorno, N. (eds.): DRG und Ethik. Ethische Auswirkungen von ökonomischen Steuerungselementen im Gesundheitswesen. Basel: EMH-Verlag, pp. 127–139.

Zimmermann-Acklin, M. 2010. Bioethik in theologischer Perspektive. Grundlagen, Methoden und Bereiche. Freiburg i. Ue. / Freiburg i. Br.: Academic Press Fribourg / Verlag Herder, 2. erw. Aufl., zuerst 2009.

Zimmermann-Acklin, M. 2009. Verlust der Ethik? Bioethik zwischen Institutionalisierung und Ideologiekritik. Bioethica Forum 3(1) (2010): 12−16.

Zimmermann-Acklin, M. / Halter, H. (eds.). 2007. Rationierung und Gerechtigkeit im Gesundheitswesen. Beiträge zur Debatte in der Schweiz. Basel: EMH-Verlag.