David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Jack Alan Reynolds
Learn more about PhilPapers
Oxford University Press (1993)
Conflicts of interest are rampant in the American medical community. Today it is not uncommon for doctors to refer patients to clinics or labs in which they have a financial interest (40% of physicians in Florida invest in medical centers); for hospitals to offer incentives to physicians who refer patients (a practice that can lead to unnecessary hospitalization); or for drug companies to provide lucrative give-aways to entice doctors to use their "brand name" drugs (which are much more expensive than generic drugs). In Medicine, Money and Morals, Marc A. Rodwin draws on his own experience as a health lawyer--and his research in health ethics, law, and policy--to reveal how financial conflicts of interest can and do negatively affect the quality of patient care. He shows that the problem has become worse over the last century and provides many actual examples of how doctors' decisions are influenced by financial considerations. We learn how two California physicians, for example, resumed referrals to Pasadena General Hospital only after the hospital started paying $70 per patient (their referrals grew from 14 in one month to 82 in the next). As Rodwin writes, incentives such as this can inhibit a doctor from taking action when a hospital fails to provide proper service, and may also lead to the unnecessary hospitalization of patients. We also learn of a Wyeth-Ayerst Labs promotion in which physicians who started patients on INDERAL (a drug for high blood pressure, angina, and migraines) received 1000 mileage points on American Airlines for each patient (studies show that promotions such as this have a direct effect on a doctor's choice of drug). Rodwin reveals why the medical community has failed to regulate conflicts of interest: peer review has little authority, state licensing boards are usually ignorant of abuses, and the AMA code of ethics has historically been recommended rather than required. He examines what can be learned from the way society has coped with the conflicts of interest of other professionals --lawyers, government officials, and businessmen--all of which are held to higher standards of accountability than doctors. And he recommends that efforts be made to prohibit and regulate certain kinds of activity (such as kickbacks and self-referrals), to monitor and regulate conduct, and to provide penalties for improper conduct. Our failure to face physicians' conflicts of interest has distorted the way medicine is practiced, compromised the loyalty of doctors to patients, and harmed society, the integrity of the medical profession, and patients. For those concerned with the quality of health care or medical ethics, Medicine, Money and Morals is a provocative look into the current health care crisis and a powerful prescription for change.
|Keywords||Medical ethics Decision making Physicians Professional ethics Medical care Cost control Conflict of interests Conflict of Interest Economics, Medical Ethics, Medical Morals Physicians|
|Categories||categorize this paper)|
|Buy the book||$29.70 new (16% off) $29.70 direct from Amazon (16% off) Amazon page|
|Call number||R725.5.R63 1993|
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
Marc A. Rodwin (2010). The Metamorphosis of Managed Care: Implications for Health Reform Internationally. Journal of Law, Medicine and Ethics 38 (2):352-364.
Barbara K. Redman & Arthur L. Caplan (2005). Off with Their Heads: The Need to Criminalize Some Forms of Scientific Misconduct. Journal of Law, Medicine and Ethics 33 (2):345-346.
Peter D. Jacobson, Elizabeth Selvin & Scott D. Pomfret (2001). The Role of the Courts in Shaping Health Policy: An Empirical Analysis. Journal of Law, Medicine and Ethics 29 (3-4):278-289.
Similar books and articles
Stephan Sahm (2013). Of Mugs, Meals and More: The Intricate Relations Between Physicians and the Medical Industry. [REVIEW] Medicine, Health Care and Philosophy 16 (2):265-273.
Samuel Gorovitz (1982/1985). Doctors' Dilemmas: Moral Conflict and Medical Care. Oxford University Press.
E. Haavi Morreim (1985). Cost Containment: Issues of Moral Conflict and Justice for Physicians. Theoretical Medicine and Bioethics 6 (3).
Delon Human (2002). Conflicts of Interest in Science and Medicine: The Physician's Perspective. Science and Engineering Ethics 8 (3):273-276.
Roy G. Spece, David S. Shimm & Allen E. Buchanan (eds.) (1996). Conflicts of Interest in Clinical Practice and Research. Oxford University Press.
M. K. Benson (1995). Medicine, Money and Morals: Physicians' Conflicts of Interest. Journal of Medical Ethics 21 (2):124-124.
Laurence B. McCullough (1999). A Basic Concept in the Clinical Ethics of Managed Care: Physicians and Institutions as Economically Disciplined Moral Co-Fiduciaries of Populations of Patients. Journal of Medicine and Philosophy 24 (1):77 – 97.
Jerome P. Kassirer (2005). On the Take: How America's Complicity with Big Business Can Endanger Your Health. Oxford University Press.
Kirsten Austad, David H. Brendel & Rebecca W. Brendel (2010). Financial Conflicts of Interest and the Ethical Obligations of Medical School Faculty and the Profession. Perspectives in Biology and Medicine 53 (4):534-544.
Added to index2009-01-28
Total downloads58 ( #29,194 of 1,101,814 )
Recent downloads (6 months)35 ( #4,784 of 1,101,814 )
How can I increase my downloads?