Abstract
Professional autonomy interferes at a structural level with the variousaspects of the health care system. The health care systems that can bedistinguished all feature a specific design of professional autonomy,but experience their own governance problems. Empirical health caresystems in the West are a nationally coloured blend of ideal type healthcare systems. From a normative perspective, the optimal health caresystem should consist of elements of all the ideal types. A workableoptimum taking national values into account could be attained bygovernance structures that also introduce elements from other ideal typesystems. Thus a normative approach to medical practice guaranteeing anessential degree of professional autonomy for a relationship of trustbetween the patient and the physician, could be combined with anefficient and equitable allocation of health care resources.
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REFERENCES
Brody H, Miller FG. The internal morality of medicine: Explication and application to managed care. Journal of Medicine and Philosophy 1998; 23(4): 384–410.
Emanuel EJ, Brett AS. Managed competition and the patient-physician relationship. New England Journal of Medicine 1993; 329: 879–882.
Enthoven AC. Theory and Practice of Managed Competition in Health Care Finance. Amsterdam: North-Holland, 1988.
Gregory PR, Stuart RC. Comparative Economic Systems. Boston: Houghton Mifflin Company, 1995.
Have HA ten. Medical technology assessment and ethics-Ambivalent relations. Hastings Center Report 1995; 25(5): 3–9.
Heitman E. Ethical issues in technology assessment. International Journal of Technology Assessment in Health Care 1998; 14(3): 544–566.
Hoogland J, Jochemsen H. Professional autonomy and the normative structure of medical practice. This volume, pp. 457–475.
Horner JS. Autonomy in the medical profession in the United Kingdom-an historical perspective. This volume, pp. 409–423.
Jakubowski E, Busse R. Health Care Systems in the EU-a Comparative Study. Luxembourg: European Parliament, 1998.
Nys H, Schotsmans P. Professional autonomy in Belgium. This volume, pp. 425–439.
Polder JJ, Hoogland J, Jochemsen H, Strijbos S. Profession, practice and profits: Competition in the core of health care system. Systems Research and Behavioral Science 1997; 14(6): 409–421.
Sacchini D, Antico L. The professional autonomy of the medical doctor in Italy. This volume, pp. 441–456.
Williamson OE. The Economic Institutions of Capitalism. New York: The Free Press, 1985.
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Polder, J.J., Jochemsen, H. Professional Autonomy in the Health Care System. Theor Med Bioeth 21, 477–491 (2000). https://doi.org/10.1023/A:1009977407106
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DOI: https://doi.org/10.1023/A:1009977407106