Important discussions about limiting care based on professional judgment often devolve into heated debates over the place of physicians in bedside rationing. Politics, loaded rhetoric, and ideological caricature from both sides of the rationing debate obscure precise points of disagreement and consensus, and hinder critical dialogue around the obligations and boundaries of professional practice. We propose a way forward by reframing the rationing conversation, distinguishing between the scale of the decision (macro vs. micro) and its context (ordinary allocation vs. extraordinary re-allocation) avoiding the word "rationing." We propose to shift the terminology, using specific, descriptive words to defuse conflict and re-focus the debate towards substantive issues. These distinctions can clarify the real ethical differences at stake and facilitate a more constructive conversation about the clinical and social responsibilities of physicians to use resources ethically at the bedside and their role in allocating medical resources at a societal level.

中文翻译：

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背景和规模：区分有关医师“配给量”的辩论的区别。

有关基于专业判断来限制护理的重要讨论通常演变成关于床位配给中医生位置的激烈辩论。配给辩论双方的政治，满腔夸张的言论和意识形态讽刺都掩盖了分歧和共识的精确点，并阻碍了围绕专业实践的义务和界限的批判性对话。我们通过限制配给对话的框架，区分决策的规模（宏观与微观）及其上下文（常规分配与非常规重新分配）来避免“定量”一词，从而提出了一种解决方案。我们建议改变术语，使用特定的描述性词语来化解冲突，并使辩论重新集中于实质性问题。