Rationing healthcare: the appeal of muddling through elegantly.

There is no denying the existence of rationing in healthcare. It is an example par excellence of a "wicked issue." Faced with the reality of rationing, the issues are: who should ration, and how rule-bound and explicit should it be? Clinicians are ambivalent on these matters. Many would prefer governments and politicians to make these decisions openly in publicly funded healthcare systems, since they decide how much to spend on healthcare. Others believe it to be the responsibility of clinicians to decide how finite resources should best be used in individual cases.