David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Jack Alan Reynolds
Learn more about PhilPapers
Journal of Medicine and Philosophy 15 (4):425-448 (1990)
A new economic phenomenon, in which physicians refer their patients to ancillary facilities of which they themselves are owners or substantial investors, presents a ‘laboratory’ for assessing philosophers' potential contributions to public policy issues. In this particular controversy, ‘prohibitionists’ who wish to ban all such self-referral focus on the dangers that patients and payers may receive or be billed for unnecessary or poor-quality care. ‘Laissez-fairists’, in contrast, argue that self-referral should be freely permitted, with a reliance on personal ethics and internal professional monitoring to guard against abuse. Undue government regulation, they argue, infringes providers' and patients' economic freedom, and stifles the competition that can yield better quality care at lower prices. As this debate features basic values and large amounts of money, it has been marked by rancorous rhetoric, shallow argument, and muddled reasoning. The philosopher's first contribution, therefore, is to expose simplistic and fallacious arguments, whether empirical, conceptual, moral, or legal. Beyond this, the philosopher can help to identify the important values at stake and, perhaps, to identify resolutions that honor those values better than the more simplistic answers proffered previously. For abusive self-referral, as distinguished from kickbacks, the author recommends that civil remedies be favored over criminal prohibitions. She suggests that the doctrine of ‘bad faith breach of contract’ might appropriately be extended into this new area to provide a powerful means by which aggrieved patients and payers can hold physicians personally accountable for abusive self-referrals. Keywords: bad faith breach of contract, civil law, criminal law, self-referral, simplistic reasoning CiteULike Connotea Del.icio.us What's this?
|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
No citations found.
Similar books and articles
Herman Nys & Paul Schotsmans (2000). Professional Autonomy in Belgium. Theoretical Medicine and Bioethics 21 (5):425-439.
Demian Whiting (2011). Abortion and Referrals for Abortion: Is the Law in Need of Change? Journal of Evaluation in Clinical Practice 17 (5):1006-1008.
A. Paige Baker (1993). Physicians' Self-Referral: Ethics Versus Economics? Office of Local Government.
Paul W. Allen & Chee K. Ng (2001). Self Interest Among CPAs May Influence Their Moral Reasoning. Journal of Business Ethics 33 (1):29 - 35.
Roy G. Spece, David S. Shimm & Allen E. Buchanan (eds.) (1996). Conflicts of Interest in Clinical Practice and Research. Oxford University Press.
Ronald M. Green (1990). Physicians, Entrepreneurism and the Problem of Conflict of Interest. Theoretical Medicine and Bioethics 11 (4).
Carolyn McLeod (2008). Referral in the Wake of Conscientious Objection to Abortion. Hypatia 23 (4):pp. 30-47.
Frederick T. Travis, Alarik T. Arenander & D. DuBois (2004). Psychological and Physiological Characteristics of a Proposed Object-Referral/Self-Referral Continuum of Self-Awareness. Consciousness and Cognition 13 (2):401-420.
Francis J. Beckwith (1996). The Ethics of Referral Kickbacks and Self-Referral and the Hmo Physician as Gatekeeper: An Ethical Analysis. Journal of Social Philosophy 27 (3):41-48.
Kevin WM Wildes (1993). Conscience, Referral, and Physician Assisted Suicide. Journal of Medicine and Philosophy 18 (3):323-328.
Added to index2010-08-19
Total downloads2 ( #386,730 of 1,410,163 )
Recent downloads (6 months)1 ( #155,015 of 1,410,163 )
How can I increase my downloads?