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dc.contributor.authorOnarheim, Kristine Husøy
dc.contributor.authorNorheim, Ole Frithjof
dc.contributor.authorMiljeteig, Ingrid
dc.date.accessioned2018-04-16T11:15:41Z
dc.date.available2018-04-16T11:15:41Z
dc.date.issued2018
dc.identifier.urihttp://hdl.handle.net/1956/17613
dc.description.abstract<p>Introduction: High healthcare costs make illness precarious for both patients and their families&rsquo; economic situation. Despite the recent focus on the interconnection between health and financial risk at the systemic level, the ethical conflict between concerns for potential health benefits and financial risk protection at the household level in a low-income setting is less understood.</p> <p>Methods: Using a seven-step ethical analysis, we examine a real-life dilemma faced by families and health workers at the micro level in Ethiopia and analyse the acceptability of limiting treatment for an ill newborn to protect against financial risk. We assess available evidence and ethical issues at stake and discuss the dilemma with respect to three priority setting criteria: health maximisation, priority to the worse-off and financial risk protection.</p> <p>Results: Giving priority to health maximisation and extra priority to the worse-off suggests, in this particular case, that limiting treatment is not acceptable even if the total well-being gain from reduced financial risk is taken into account. Our conclusion depends on the facts of the case and the relative weight assigned to these criteria. However, there are problematic aspects with the premise of this dilemma. The most affected parties&mdash;the newborn, family members and health worker&mdash;cannot make free choices about whether to limit treatment or not, and we thereby accept deprivations of people&rsquo;s substantive freedoms.</p> <p>Conclusion: In settings where healthcare is financed largely out-of-pocket, families and health workers face tragic trade-offs. As countries move towards universal health coverage, financial risk protection for high-priority services is necessary to promote fairness, improve health and reduce poverty.</p>eng
dc.language.isoengeng
dc.publisherBMJeng
dc.relation.ispartof<a href="http://hdl.handle.net/1956/17619" target="_blank">Priority to the newborn? Real-life priority setting and intra-household resource allocation for newborn health in Ethiopia</a>
dc.rightsAttribution CC BY-NCeng
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/eng
dc.titleNewborn health benefits or financial risk protection? An ethical analysis of a real-life dilemma in a setting without universal health coverageeng
dc.typeJournal articleeng
dc.rights.holderCopyright 2018 The Author(s)eng
dc.type.versionpublishedVersioneng
bora.peerreviewedPeer reviewedeng
bora.journalTitleJournal of Medical Ethicseng
dc.identifier.doi10.1136/medethics-2017-104438eng
dc.source.issn0306-6800eng
dcterms.isPartOfhttp://hdl.handle.net/1956/17619


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Except where otherwise noted, this item's license is described as Attribution CC BY-NC