Asignación de recursos en salud en Chile: consideraciones éticas en la toma de decisión / Ethical considerations about decision making in health care source allocation in Chile

RESUMO

Background: The inclusion of ethical aspects in the world health care reform is currently being discussed. Aim: To analyze the ethical component of health care decision making in Chile. Material and methods: A qualitative analysis of interviews with 4 health service directors, 4 public hospital directors and 1 sub director. Inquiries to 16 public hospital ethics committees, about importance of ethical components in decision making, role of ethics committees in financial issues and the feasibility of incorporation explicit ethical considerations in decision making. Results: There is an absence of explicit ethical criteria in decision making. There is little participation of directors in these issues and lack of information. Although ethical aspects are considered relevant, they are not taken into account. Ethics committees are mostly dedicated to evaluate research protocols. The community is not mentioned as a relevant actor in decision making about resource allocation. Conclusions: Health service directors and all health care personnel should be trained in bioethics. These aspects should be incorporated to their daily work