ABSTRACT
This chapter examines the question of rationing in the NHS, and identifies some of the ethical dilemmas and legal issues that it produces. The complexity of the fair allocation of resources in the health service requires considerable and sometimes inconclusive debate. There are two main ethical issues that face the General Practitioner (GP) when considering how best to allocate resources. First, inherent in the individual patients perceived need for treatment is the requirement to respect his autonomy and to benefit him with the treatment. Second, the principle of justice takes into account the fact that many other patients and would-be patients have clinical needs. In law, the question of needs or wants could be resolved on the basis of either Bolam or Wednes-burydepending on whether it was a clinical-or a resource-based problem. The utilitarian manager may consider spreading resources ever more thinly in an attempt to achieve equity for the population.
