Medical resource allocation: rationing and ethical considerations--Part I

The United States' system of high-quality but expensive and poorly distributed medical care is in trouble. Dramatic advances in medical knowledge and procedures, combined with soaring demands created by growing public awareness, the cost of private hospital and medical insurance, and Medicare and Medicaid, are burdening the medical care delivery systems. The costs of medical care have reached levels that can no longer be sustained. Government officials, insurance planners, labor leaders responsible for union health care benefits, and ordinary citizens are questioning whether it is acceptable to limit health care based on economic considerations. If health care is deemed a social good, the method of allocation must be addressed. Unless society decides that other priorities of the infrastructure are to be subjugated to health service delivery, difficult decisions will be forced upon us, consciously or by default. The discussion in this two-part article explores the ethical considerations of the more formalized approaches to resource allocation that presently exist in our society

Medical resource allocation: rationing and ethical considerations, Part II

The proliferation of medical technology during the past decade has doubtless surpassed that of any other recent period. We have witnessed and are continuing to witness rapid advances in human genetic engineering, reproductive technology, and biomedical intervention in the life process. Our population has benefitted from this technology as a result of its ability to extend the life of individuals, particularly the elderly sector of our society. This technological proliferation has caused philosophers, physicians, engineers, and policy strategists to focus upon questions of ethics and mortality relating to their application. In approaching the ethics of rationing, consideration must be given to both the deontological concepts of the individual and the utilitarian principles of societal preservation. This article continues a discussion of the issues of resource allocation that was begun in the February 1994 issue of Physician Executive

Study of a 1 eV GaNAsSb photovoltaic cell grown on a silicon substrate

We report the performance of a 1 eV GaNAsSb photovoltaic cell grown on a Si substrate with a SiGe graded buffer grown using molecular beam epitaxy. For comparison, the performance of a similar 1 eV GaN0.018As0.897 Sb 0.085 photovoltaic cell grown on a GaAs substrate was also reported. Both devices were in situ annealed at 700 °C for 5 min, and a significant performance improvement over our previous result was observed. The device on the GaAs substrate showed a low open circuit voltage (VOC) of 0.42 V and a short circuit current density (JSC) of 23.4 mA/cm2 while the device on the Si substrate showed a VOC of 0.39 V and a JSC of 21.3 mA/cm2. Both devices delivered a quantum efficiency of 50%–55% without any anti-reflection coating.Published versio