A Balancing Act: Ethics and Resource Allocation in Health Care
The Nova Scotia Health Ethics Network acknowledges we are in Mi’kma’ki – the unceded territory and ancestral homeland of the Mi’kmaq Nation. We are All Treaty people. We also acknowledge histories, contributions, and legacies of the African Nova Scotian people who have been in these territories for over 400 years. Health inequities in many communities, including Mi’kmaq and African Nova Scotian communities, have often been exacerbated by resource allocation decisions. We approach this discussion about resource allocation with awareness of the need to address these and other systemic injustices.
At the end of this conference, participants will be able to:
- Identify situations within healthcare where resource allocation decisions raise ethical questions and concerns
- Describe typical ethical questions related to resource allocation
- Identify values and principles that are relevant when making decisions about resource allocation
- Apply ethics tools and frameworks to situations where values must be balanced in making decisions about resource allocation
Resource Allocation and Ethics
Marika Warren, Ph.D., Network Ethicist, Nova Scotia Health Ethics Network
These interactions are structured to promote discussion about the realities of addressing ethical challengees in practice settings; they are not intended as demonstrations of what to do or what not to do.
These interactions are semi-scripted scenarios designed to illustrate some of the ways that ethical challenges arise and are addressed in healthcare practice. The opinions expressed are not necessarily those of the individuals involved, even if they have chosen to use their real names in the simulation.
Managing the Workflow – Simulated Conversation
with Tanya Dutton, in conversation with Blake Pleeters (simulated patient as played by Dragana Sparavalo)
Bad News About Resource Allocation – Simulated Conversation
with Dr. Sarah Smith (played by Dr. Sarah Shea) in conversation with Lou Benjamin (simulated patient as played by Annie LaPlante)
Resource Allocation in Practice
Panel Discussion with:
Farhana Kanth, Manager of Policy, Safety Branch, Department of Labour, Skills and Immigration
Jessica Mills, Pediatric General and Thoracic Surgeon, IWK Health
Dylana Arsenault, Executive Director, Hospital Services and Patient Flow, Health PEI
Catherine Buckie, Patient Family Advisor, Nova Scotia Health
Resource Allocation – Strategies and Tools
Christy Simpson, Ethics Collaboration Coordinator Dept. of Bioethics, Dalhousie University
Conferences are always labour-intensive, and with the additional challenges and demands stemming from the COVID-19 pandemic we are especially grateful to all of the following individuals for their invaluable contributions.
We would like to thank Tanya Dutton, Farhana Kanth, Jessica Mills, Dylana Arsenault, Catherine Buckie, Dr. Sarah Shea, and Dr. Christy Simpson, for their time, for their patience, and for the keen insights that they shared as well as for contributing resources to help guide discussion.
Thank you to both the simulated patients, Annie LaPlante and Dragana Sparavalo, and the actual health care providers, Sarah Shea and Tanya Dutton, who made our simulated healthcare encounters come alive. Our gratitude also goes to Jacquie Thillaye with the Dalhousie Centre for Collaborative Clinical Learning and Research for support with developing the scenarios.
Thank you to Matthew Stones and Jordan Urquhart from Dalhousie MedIT, who provided expert support to us and to the panelists and who went above and beyond to ensure that everything looks and sounds as good as possible given the circumstances.
Thank you to NSHEN’s Lisbeth Witthoefft Nielsen and Krista Mleczko-Skerry for all of their efforts in making the behind-the-scenes work go smoothly!
Thank you to members of the NSHEN Advisory Council, the IWK Ethics Committee, and Ethics Nova Scotia Health Ethics Leads Group for providing guidance around conference content.
Finally, thank you, the viewer, for engaging with the hard questions that are raised in these sessions; as always the promise of ethics support is not that we will give you the “right” answer but that we will help you to ask the right questions to assist you in identifying the values at play as you find your way to a defensible, “more-right” (or “less-bad”) decision.
Marika Warren, Ph.D.
Network Ethicist, Nova Scotia Health Ethics Network