Conversations in ethics: allocation of scarce resources.

Abstract

The healthcare facility was experiencing a high census and as a result was out of labor/delivery/ recovery/postpartum rooms, necessitating some patients be moved to smaller rooms in the pediatric unit according to the facility’s protocol. One family that was approached refused to be moved, and an altercation occurred, causing the charge nurse significant distress. The charge nurse in the birthing center approached the department head for advice regarding the allocation of resources. The department head was somewhat confused by the inquiry, because there were numerous other patients that could be approached. When questioned, the charge nurse indicated that the alternate families had insurance and were ‘‘paying’’ clients of the facility, whereas the first family approached was without resources other than Medicaid. The nurse felt that those who were not paying for their healthcare through either their own resources or insurance should not be able to refuse reasonable requests regarding the allocation of facilities. When advised by the department head that the source of payment, if any, was irrelevant, the charge nurse continued to defend her position and maintained that those who paid had more ‘‘rights’’ than those who did not. .................................................