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Title: Resource allocation and rationing in nursing care: A discussion paper
Authors: Scott, P Anne 
Harvey, Clare 
Felzmann, Heike 
Suhonen, Riitta 
Habermann, Monika 
Halvorsen, Kristin 
Christiansen, Karin 
Toffoli, Luisa 
Papastavrou, Evridiki 
Major Field of Science: Medical and Health Sciences
Field Category: Health Sciences
Keywords: Care left undone;Missed nursing care;Nursing care;Rationing;Resource allocation
Issue Date: Aug-2019
Source: Nursing Ethics, 2019, vol. 26, no. 5, pp. 1528-1539
Volume: 26
Issue: 5
Start page: 1528
End page: 1539
Journal: Nursing Ethics 
Abstract: Driven by interests in workforce planning and patient safety, a growing body of literature has begun to identify the reality and the prevalence of missed nursing care, also specified as care left undone, rationed care or unfinished care. Empirical studies and conceptual considerations have focused on structural issues such as staffing, as well as on outcome issues – missed care/unfinished care. Philosophical and ethical aspects of unfinished care are largely unexplored. Thus, while internationally studies highlight instances of covert rationing/missed care/care left undone – suggesting that nurses, in certain contexts, are actively engaged in rationing care – in terms of the nursing and nursing ethics literature, there appears to be a dearth of explicit decision-making frameworks within which to consider rationing of nursing care. In reality, the assumption of policy makers and health service managers is that nurses will continue to provide full care – despite reducing staffing levels and increased patient turnover, dependency and complexity of care. Often, it would appear that rationing/missed care/nursing care left undone is a direct response to overwhelming demands on the nursing resource in specific contexts. A discussion of resource allocation and rationing in nursing therefore seems timely. The aim of this discussion paper is to consider the ethical dimension of issues of resource allocation and rationing as they relate to nursing care and the distribution of the nursing resource.
ISSN: 0969-7330
DOI: 10.1177/0969733018759831
Rights: Creative Commons Attribution-NonCommercial 4.0 License
Type: Article
Affiliation : National University of Ireland 
Central Queensland University 
University of Turku 
Hochschule Bremen 
Oslo Metropolitan University 
VIA University College 
University of South Australia 
Cyprus University of Technology 
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