Abstract

The structural scarcity of healthcare resources raises im- portant bioethical issues regarding their allocation, such as who should make such decisions. This paper evaluates whether or not physicians should be responsible for deciding how to allocate healthcare resources in the micro-allocation context. Addressing this issue is essential for determining the moral or legal responsibility of physicians when allocating scarce healthcare resources in both ordinary and emer- gency conditions. The paper is structured as follows: First, I discuss the perspective of the physician as a double agent, balancing their duty to their patient with that towards other patients and society. This perspective aims to justify bedside rationing by physicians. After discussing some critical issues with this conception, I propose a critique based of the prin- ciple of justice. I then define the necessary requirements for a fair and legitimate allocation choice in healthcare and argue that the specificity of such a choice makes it morally problematic to attribute a direct decision-making role to the treating physician when rationing healthcare resources in the micro-allocation context. This leads to a rejection of the conception of the physician as a double agent and bedside rationing, although I observe that this does not preclude the physician from some involvement in the process of defining allocation criteria and methods.