Date of Award


Degree Type


Degree Name

Master of Science


Health and Rehabilitation Sciences


Dr. Ken Kirkwood

Second Advisor

Dr. Anne Kinsella

Third Advisor

Dr. Marilyn Evans


In any health care system where funds are limited, priorities must be set. Resource allocation, also called priority setting or rationing, may determine who receives treatment, what treatment they receive, or amount of time spent with professionals. Bedside rationing decisions are those which health care professionals make at the clinical level. Ethical distress and residue theory may inform the investigation of discomfort and conflict identified in physicians who ration care. Ethical distress is experienced when external constraints make it nearly impossible to do “the right thing,” and ethical residue represents the traces which remain following unresolved ethical distress. This study aims to explore how physicians negotiate ethical residue associated with making bedside rationing decisions on an ongoing basis, using a grounded theory methodology. The findings indicate that “doing everything I think patients need” is central to this process. Findings may inform medical ethics education and training interventions for practicing physicians.



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.