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Table 1 Topics related to resource issues treated in seminars (S), individual patient case discussions (I), and principled/general case discussions (P)

From: Roles and responsibilities of clinical ethics committees in priority setting

Topics Examples
Introduction of new costly drugs New, costly drug for cystic fibrosis (P); co-payment for expensive drugs (I + P)
Extraordinarily costly established/existing treatment Costly treatment for patient with rare condition (I); home ventilator treatment (I); costly drug for serious and rare psychiatric disease (I); requirements for patient conduct and compliance when treatment is particularly expensive (I)
Application of priority criteria Age limits for lung transplantation (P); triage in the emergency department (P); Caesarean section “on demand” (S); priority setting in rehabilitation medicine (S); discussion of national priority setting criteria (S)
Resource use for potentially vulnerable groups Illegal immigrant with serious chronic disease and repeated admissions (I); repeated cardiac surgery for substance abusers (P); priority setting when medical evidence is scarce (P)
Budget/resource constraints compromising good practice The incompatible logics of “care” and “production” (S); reductions in staff and number of beds leading to poorer services (P); transfer of imminently dying patients to nursing homes (P); early discharge from hospital due to resources constraints (I)
Futility of care Expensive life-prolonging treatment with questionable benefits (I); priority setting in intensive care (S)