Exploring the Concept of “Waste” in Clinical Decision-Making and Healthcare Policies

Abstract: The concept of “waste” has numerous meanings in clinical decision-making and healthcare policies. The imperative to eliminate waste has become an especially timely consideration in the 2025 political landscape. This panel brings together experts from diverse backgrounds to explore the concept of “waste.” The first panelist, an infectious disease and transplant physician, will analyze “waste” contrasted with “stewardship.” Individuals and organizations have duties to serve as good stewards of scarce health resources, including antimicrobials and donor organs. The panelist will explore how these stewards understand and use "waste" to make and justify decisions at individual, organizational, and policy levels. The second panelist, a clinical ethicist, will evaluate how concerns about “efficiency” are often rooted in concerns about waste, but ableism, ageism, and other biases can undergird assumptions about efficient use of resources. Case vignettes will illustrate how concerns about waste can inequitably impact patient care. The third panelist, a bioethicist working at the intersection of climate change and public health, will reflect critically on the concept of healthcare “waste” regarding single-use plastics and disposal practices (incineration, landfilling, etc.), highlighting environmental (in)justice. The fourth panelist, a bioethicist and legal scholar, will discuss how waste is invoked to dodge inescapable ethical tradeoffs in health insurance and resource allocation. The panelist will consider whether wasteful policies must be inferior in each respect or merely inferior overall. The panelist will also discuss parallel challenges in defining “waste” and “futility.” The panel will engage the audience in their experiences regarding meanings and implications of waste.

Keywords: Justice, Resource allocation, Stewardship