Physicians are often asked to be “gatekeeper,” determining their patients' access to medical technologies.

At the same time, most physicians have been taught they should act as patient advocates, pursuing patients' best interests regardless of cost, according to Peter A. Ubel, associate professor of medicine, and director of the program on medical decision-making at the University of Michigan.

Ubel will give the annual Labelle Lecture, titled “The Unbearable Rightness of Bedside Rationing,” on Wednesday, Oct. 18 at 1 p.m. in Room 1A1, Health Sciences Centre.

Ubel will review the moral arguments ethicists have made for and against “bedside rationing.” He will also discuss two surveys that he and his colleagues have conducted to explore physicians' attitudes toward cost-effectiveness and cancer-screening decisions.

According to Ubel, physicians are in deep conflict about their roles in cost-containment. Some of the conflict has to do with discomfort over the concept of “rationing” and other deeper issues.

Ubel recently moved to Michigan from Pennsylvania where he was assistant professor of medicine at the University of Pennsylvania and a staff physician at the Philadelphia VA. While at Penn, Ubel published widely about topics in medical-decision making and ethics.

Some of his research focused on the moral and social implications of cost-effective analysis, and was summarized in his recently published book, Pricing Life: Why is it Time for Health Care Rationing?.

Ubel is principal investigator on three National Institute of Health projects, has won career development awards from the Robert Woods Foundation and the Department of Veterans Affairs. Earlier this year, he received a presidential Early Career Award for Scientists and Engineers.

Professor of philosophy and director of the Centre for Professional and Applied Ethics, Arthur Scafer, joins Ubel as a lecture discussant. Schafer, an ethics consultant, is the recipient of a number of awards and honours, and is published widely in the fields of moral, social, and political philosophy.

He is the author of The Buck Stops Here: Reflections on Moral Responsibility, Democratic Accountability and Military Values, and the editor of Ethics and Animal Experimentation

The Labelle Lectureship Series in Health Services Research was established to provide an opportunity for researchers to renew themselves in the spirit of resilient optimism that was hers, and to remind them of her message that good research can really make a difference.

Roberta Labelle was an assistant professor in the Faculty of Health Sciences at McMaster University, and a member of the Department of Clinical Epidemiology & Biostatistics, and the Centre for Health Economics and Policy Analysis. She was a “rising star” in her field, who died suddenly in 1991 at age 33.