%0 Journal Article
%T The Ethics of Prioritizing Access to Palliative Care: A Qualitative Study
%A Anna Collins
%A Bethany Russell
%A Brian Le
%A Caroline Brand
%A Jennifer Philip
%A Peter Hudson
%A Vijaya Sundararajan
%J American Journal of Hospice and Palliative Medicine£¿
%@ 1938-2715
%D 2019
%R 10.1177/1049909119833333
%X Palliative care services are increasingly required to consider issues of resource, management as demand for services increases. The processes of triage have been developed in health care as a means of balancing need and resources in an equitable and reproducible way. This article sought to explore ethical issues associated with prioritization decisions in palliative care. As part of a broader series of studies of triage in palliative care, this qualitative substudy was conducted via semi-structured focus groups and individual interviews. Transcripts were subjected to thematic analysis. Twenty health professionals working across disciplines (primary, specialist; medicine, nursing, and allied health), service types (inpatient, hospital liaison, and community), and locations (metropolitan and rural) in Victoria, Australia. Four themes emerged from the data: (1) Clinicians understood the tension between maintaining service quality with the delivery of a compromised service that sought to respond to demand. (2) They were aware of the influences of relationships and responsibilities upon patient waiting list prioritization, and (3) reported a hierarchy of suffering with certain types of clinical problems viewed as more urgent than others, for example, pain being more urgent than existential distress. (4) Clinicians noted a lack of transparency around waiting lists as they currently exist. This study revealed key ethical decision-making issues associated with prioritizing access to palliative care services. Making explicit the processes and influences upon decision-making provides greater transparency of health-care utilization at the end of life
%K palliative care
%K triage
%K waiting lists
%K ethics
%K resource allocation
%U https://journals.sagepub.com/doi/full/10.1177/1049909119833333