68. Case: Big Yellow Taxi

Following the bankruptcy of the local taxi service, a community hospital recognized that several of its frail, elderly patients who don’t drive had exceedingly limited options for getting to the hospital for their appointments. A few community volunteers were able to help out in the short term, but increasingly found that they were not necessarily able to keep up with the need or cover all of their gas and insurance costs on their own. Some hospital leaders argue that paying for these transportation costs may actually decrease overall costs for the organization, as this should lead to fewer emergencies and a greater involvement by these patients in maintaining their health. However, finding the money to cover the transportation costs and determining more concretely who will or will not qualify for this service will not be easy. Others argue that this isn’t a cost that the hospital should take on and that this is something that the community or the province needs to address.

What ethics issues do you identify in this case?

What values are involved in this case (e.g., equity, fairness, trust, good care…)?

How might this issue be different in a rural setting as compared to an urban setting? Is this a relevant factor to consider in determining what should be done?

Resources:

Asthana, S., A. Gibson, G. Moon, and P. Brigham. 2003. Allocating resources for health and social care: the significance of rurality. Health and Social Care in the Community. 11:6 486-493.

Danis M. 2008. The Ethics of allocating resources toward rural health and health care. In Klugman C, and Dalinis P eds. Ethical Issues in Rural Health Care Johns Hopkins University Press Baltimore Maryland 71-98.

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