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To choose who should live: a bioethical study of social criteria to microallocation of health care resources in medical emergencies

OBJECTIVE: To analyze ethical dilemmas about microallocation of health care scarce resources, based on deontological and utilitarian bioethical basis. It analyzes some criteria considered in the choices and justifications for patients selection in medical emergencies.METHODS: 395 subjects were interviewed in the city of Diadema/SP, about dilemmas among two people needing a place in a public hospital of emergency service. The presented situations dealed with the following social criteria: age, sex, social responsibility and economical condition.RESULTS: They pointed that significant portion of those researched seems to consider that the use of social criteria is valid and that the people lives can have unequal value in situations of scarce resources, accepting social variables to prioritize in situations of evidenced medical emergency.CONCLUSIONES: It could be evoked the coexistence of deontological orientations, defending the more "weak and vulnerable", and utilitarian positions, opting for the potential and life expectation as well as for the social responsibility.

Bioethics; Health care rationing; Selection of patients; Institutional ethics; Equity; Utilitarianism


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