A basic concept in the clinical ethics of managed care: Physicians and institutions as economically disciplined moral co-fiduciaries of populations of patients
David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Jack Alan Reynolds
Learn more about PhilPapers
Journal of Medicine and Philosophy 24 (1):77 – 97 (1999)
Managed care employs two business tools of managed practice that raise important ethical issues: paying physicians in ways that impose conflicts of interest on them; and regulating physicians' clinical judgment, decision making, and behavior. The literature on the clinical ethics of managed care has begun to develop rapidly in the past several years. Professional organizations of physicians have made important contributions to this literature. The statements on ethical issues in managed care of four such organizations are considered here, the American Medical Association, the American College of Physicians, the American College of Obstetricians and Gynecologists, and the American Academy of Pediatrics. Three themes common to these statements are identified and critically assessed: the primacy of meeting the medical needs of each individual patient; disclosure of conflicts of interest in how physicians are paid; and opposition to gag orders. The paper concludes with an argument for a basic concept in the clinical ethics of managed care: physicians and institutions as economically disciplined moral co-fiduciaries of populations of patients.
|Keywords||No keywords specified (fix it)|
|Categories||categorize this paper)|
Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
|Through your library|
References found in this work BETA
No references found.
Citations of this work BETA
Blumenthal-Barby (2013). “Choosing Wisely” to Reduce Low-Value Care: A Conceptual and Ethical Analysis. Journal of Medicine and Philosophy 38 (5):559-580.
Similar books and articles
Kenneth A. De Ville (1999). Managed Care and the Ethics of Regulation. Journal of Medicine and Philosophy 24 (5):492 – 517.
Jacqueline K. Eastman, Kevin L. Eastman & Michael A. Tolson (2001). The Relationship Between Ethical Ideology and Ethical Behavior Intentions: An Exploratory Look at Physicians' Responses to Managed Care Dilemmas. [REVIEW] Journal of Business Ethics 31 (3):209 - 224.
J. Warren Salmon, William White & Joe Feinglass (1990). The Futures of Physicians: Agency and Autonomy Reconsidered. Theoretical Medicine and Bioethics 11 (4).
Edmund D. Pellegrino (1997). Managed Care at the Bedside: How Do We Look in the Moral Mirror? Kennedy Institute of Ethics Journal 7 (4):321-330.
Allen Buchanan (2000). Trust in Managed Care Organizations. Kennedy Institute of Ethics Journal 10 (3):189-212.
Patricia Illingworth (2000). Bluffing, Puffing and Spinning in Managed-Care Organizations. Journal of Medicine and Philosophy 25 (1):62 – 76.
Marc A. Rodwin (2010). The Metamorphosis of Managed Care: Implications for Health Reform Internationally. Journal of Law, Medicine & Ethics 38 (2):352-364.
George G. J. Agich (1999). The Importance of Management for Understanding Managed Care. Journal of Medicine and Philosophy 24 (5):518 – 534.
Cindy A. Stearns (1997). How Physicians Lost Out to Managed Care: A Case Study of Accommodation and Resistance in a Medical Community. Journal of Medical Humanities 18 (4):261-271.
Laurence B. McCullough (1999). Moral Authority, Power, and Trust in Clinical Ethics. Journal of Medicine and Philosophy 24 (1):1 – 3.
Added to index2009-01-28
Total downloads12 ( #205,927 of 1,725,989 )
Recent downloads (6 months)3 ( #231,316 of 1,725,989 )
How can I increase my downloads?