Abstract：
Classical dilemmas of how to distribute limited resources have been rekindled by the rise of advanced, high-cost therapies. Building on a case study of a novel gene therapy in neuropaediatric care, this article explores the dilemmas that explicit priority setting can create for frontline professionals and develops a typology of professionals\' responses to these dilemmas. Despite political attempts to centralise priority setting and spare health professionals from having to consider treatment costs at the \'bedside\', this study shows that concern for economic efficiency and budget control nonetheless need to be handled and balanced against other accountabilities in the daily work of frontline professionals. Contributing to the sociological debate on priority setting and rationing, this study develops an analytical perspective attuned to the relational aspects of frontline work and the challenges related to the balancing of diverging ideas of good conduct. Further, focussing on an empirical field at the forefront of genomic medicine, this study brings the sociological debate on priority setting and rationing up to date with current developments in precision medicine.
摘要：
如何分配有限资源的经典困境已被先进的,高成本的疗法。建立在神经儿科护理中一种新型基因疗法的案例研究，本文探讨了明确的优先级设置可以为一线专业人员创造的困境，并开发了专业人员对这些困境的反应类型。尽管政治上试图集中优先级设置，并使卫生专业人员不必在“床边”考虑治疗费用，这项研究表明，在前线专业人员的日常工作中，仍然需要处理对经济效率和预算控制的关注，并与其他责任相平衡。促进关于优先权设定和配给的社会学辩论，这项研究发展了一种分析视角，适应了前线工作的关系方面，以及与平衡不同的良好行为理念相关的挑战。Further,专注于基因组医学前沿的经验领域，这项研究使关于优先级设置和配给的社会学辩论与当前精准医学的发展保持同步。
