The internal morality of medicine: Explication and application to managed care

Journal of Medicine and Philosophy

Volumn 23, Issue 4, 1998, Pages 384-410

  Brody, Howard ^a   Miller, Franklin G ^b  

^a MICHIGAN STATE UNIVERSITY   (United States)

^b UNIVERSITY OF VIRGINIA   (United States)

Author keywords

Internal morality; Managed care; Medical ethics; Medicine; Profession; Professional integrity

Indexed keywords

ANALYTICAL APPROACH; ARTICLE; BIOETHICS AND PROFESSIONAL ETHICS; CONTRACT; HEALTH CARE AND PUBLIC HEALTH; HEALTH INSURANCE; HUMAN; INTERPERSONAL COMMUNICATION; MEDICAL ETHICS; MORALITY; PHILOSOPHY; PROFESSIONAL MISCONDUCT; RESOURCE ALLOCATION; SOCIAL PSYCHOLOGY; STANDARD; TREATMENT WITHDRAWAL; TRUST; UNITED STATES;

ANALYTICAL APPROACH; BIOETHICS AND PROFESSIONAL ETHICS; HEALTH CARE AND PUBLIC HEALTH;

CONTRACTS; DISCLOSURE; ETHICS, MEDICAL; HUMANS; MANAGED CARE PROGRAMS; MORAL OBLIGATIONS; MORALS; PHILOSOPHY; PHILOSOPHY, MEDICAL; POSTMODERNISM; PROFESSIONAL MISCONDUCT; RESOURCE ALLOCATION; SOCIAL VALUES; TRUST; UNITED STATES; WITHHOLDING TREATMENT;

EID: 0032082710     PISSN: 03605310     EISSN: None     Source Type: Journal    
DOI: 10.1076/jmep.23.4.384.2572     Document Type: Article

References (58)

1. Andre, J.A. (1991). 'Role morality as a complex instance of ordinary morality,' American Philosophical Quarterly 28, pp. 73-79.
2. Anonymous (1996a). 'The goals of medicine: Setting new priorities,' Hastings Center Report 26(6), pp. S1-S28.
3. Anonymous (1996b). 'Maryland: HMOs, physicians reach accord on regulatory issues before assembly,' BNA Health Care Daily Feb. 1, p. d8.
4. Anonymous (1996c). 'Massachusetts: State bans health insurers' inclusion of gag rules in care provider contracts,' BNA Health Care Daily Jan. 25, p. d14.
5. Benrubi, G.I. (1992). 'Euthanasia - The need for procedural safeguards,' New England Journal of Medicine 326, pp. 197-199.
6. Brody, H. (1989). 'Ethics of gatekeeper role (letter),' Journal of Family Practice 29, p. 443.
7. Brody, H. (1992). The Healer's Power, Yale University Press, New Haven.
8. Brody, H. (1994). 'The physician's role in determining futility,' Journal of the American Geriatrics Society 42, pp. 875-878.
9. Brody, H. (1996). 'Common fallacies that stall discussions about ethical issues in managed care,' Family Medicine 28, pp. 657-659.
10. Brody, H. (1997). 'Medical futility: A useful concept,' in M.B. Zucker and H. Zucker (eds.), Medical Futility, Cambridge University Press, New York.
11. Calabrese, M. and Canham-Clyne, J. (1995). 'Medicare bandits: The GOP plan will enrich the fast-buck HMO mills,' Washington Post Oct. 22, p. C2.
12. Carrick, P. (1985). Medical Ethics in Antiquity: Philosophical Perspectives on Abortion and Euthanasia, D. Reidel, Boston.
13. Cassell, E.J. (1991). The Nature of Suffering and the Goals of Medicine, Oxford University Press, New York.
14. Clancy, C.M. and Brody, H. (1995). 'Managed care: Jekyll or Hyde?' Journal of the American Medical Association 273, pp. 338-339.
15. Coulehan, J.L. (1995). 'Tenderness and steadiness: Emotions in medical practice,' Literature and Medicine 14, pp. 222-236.
16. Council on Ethical and Judicial Affairs, A.M.A. (1991). 'Sexual misconduct in the practice of medicine,' Journal of the American Medical Association 266, pp. 2741-2745.
17. Crawshaw, R., Rogers, D.E., Pellegrino, E.D., Bulger, R.J., Lundberg, G.D., Bristow, L.R., Cassel, C.K., and Barondess, J.A. (1995). 'Patient-physician covenant,' Journal of the American Medical Association 273, p. 1553.
18. Eddy, D.M. (1991). 'The individual vs. society: Resolving the conflict,' Journal of the American Medical Association 265, pp. 2399-2406.
19. Eddy, D.M. (1993). 'Broadening the responsibilities of practitioners: The team approach,' Journal of the American Medical Association 269, pp. 1849-1855.
20. Emanuel, E.J. (1991). The Ends of Human Life: Medical Ethics in a Liberal Polity, Harvard University Press, Cambridge.
21. Felder, M. (1992). 'An ethics committee for an HMO: An oxymoron? Certainly not!' HEC Forum 4, pp. 261-267.
22. Franks, P., Clancy, C.M., and Nutting, P.A. (1992). 'Gatekeeping revisited - Protecting patients from overtreatment,' New England Journal of Medicine 327, pp. 424-429.
23. Gadow, S. (1980). 'Existential advocacy: Philosophical foundations of nursing,' in S.F. Spicker and S. Gadow (eds.), Nursing, Images and Ideals: Opening Dialogue with the Humanities, Springer Publishing Company, New York, pp. 79-101.
24. Gartrell, N., Herman, J., Olarte, S. et al. (1986). 'Psychiatrist-patient sexual contact: Results of a national survey, I: Prevalence,' American Journal of Psychiatry 143, pp. 1126-1131.
25. Gaylin, W., Kass, L.R., Pellegrino, E.D. et al. (1988). 'Doctors must not kill,' Journal of the American Medical Association 259, pp. 2139-2140.
26. Gianelli, D.M. (1996). 'Bound and gagged: AMA: Unethical managed care rules stifle communication,' American Medical News 39(5), Feb., pp. 1,26.
27. Greenfield, S., Rogers, W., Mangotich, M., Carney, M.F., and Tarlov, A.R. (1995). 'Outcomes of patients with hypertension and non-insulin-dependent diabetes mellitus treated by different systems and specialists: Results from the Medical Outcomes Study,' Journal of the American Medical Association 274, pp. 1436-1444.
28. Hall, M.A. (1994). 'Rationing health care at the bedside,' New York University Law Review 69, pp. 693-780.
29. Kassirer, J.P. (1995). 'Managed care and the morality of the marketplace,' New England Journal of Medicine 333, pp. 50-52.
30. Ladd, J. (1983). 'The internal morality of medicine: An essential dimension of the physician-patient relationship,' in E. Shelp (ed.), The Clinical Encounter, Kluwer Aacademic Publishers, Dordrecht, pp. 209-231.
31. Ladd, J. (1989). 'The good doctor and the medical care of children,' in L.M. Kopelman and J.C. Moskop (eds.), Children and Health Care: Moral and Social Issues, Kluwer Academic Publishers, Dordrecht, pp. 281-302.
32. La Puma, J. (1994). 'Anticipated changes in the doctor-patient relationship in the managed care and managed competition of the Health Security Act of 1993,' Archives of Family Medicine 3, pp. 665-671.
33. LaPuma, J., Stocking, C.B., LaVoie, D., and Darling, C.A. (1991). 'When physicians treat members of their own families: Practices in a community hospital,' New England Journal of Medicine 325, pp. 1290-1294.
34. Lavizzo-Mourey, R., Clayton, L.A., Byrd, W.M., Johnson, G., and Richardson, D. (1996). 'The perceptions of African-American physicians concerning their treatment by managed care organizations,' Journal of the National Medical Association 88, pp. 210-214.
35. Levinsky, N.G. (1984). 'The doctor's master,' New England Journal of Medicine 311, pp. 1573-1575.
36. Levinson, D.F. (1987). 'Toward full disclosure of referral restrictions and financial incentives by prepaid health plans,' New England Journal of Medicine 317, pp. 1729-1731.
37. Lief, H.I. and Fox, R.C. (1963). 'Training for "detached concern" in medical students,' in H.I. Lief, V.F. Lief, and N.R. Lief (eds.), The Psychological Basis for Medical Practice, Harper and Row, New York, pp. 12-35.
38. Maclntyre, A. (1981). After Virtue, Notre Dame University Press, South Bend.
39. Maule, W.F. (1994). 'Screening for colorectal cancer by nurse endoscopists,' New England Journal of Medicine 330, pp. 183-187.
40. Miles, S.H. and Koepp, R. (1995). 'Comments on the AMA report "Ethical Issues in Managed Care,"' Journal of Clinical Ethics 6, pp. 306-311.
41. Miller, F.G. and Brody, H. (1995). 'Professional integrity and physician-assisted death,' Hastings Center Report 25(3), pp. 8-17.
42. Morreim, E.H. (1991). Balancing Act: The New Medical Ethics of the New Medicine's Economics, Kluwer Academic Publishers, Boston.
43. Osler, W. (1926). Aequanimitas, With Other Addresses to Medical Students, Nurses, and Practitioners of Medicine, Blakiston, Philadelphia.
44. Payer, L. (1989). Medicine and Culture: Varieties of Treatment in the United States, England, West Germany, and France, Penguin Books, New York.
45. Pellegrino, E.D. and Thomasma, D.C. (1981). A Philosophical Basis of Medical Practice, Oxford University Press, New York.
46. Pellegrino, E.D. and Thomasma, D.C. (1988). For the Patient's Good: The Restoration of Beneficence in Health Care, Oxford University Press, New York.
47. Rothman, D.J. (1991). Strangers at the Bedside: A History of How Law and Bioethics Transformed Medical Decision Making, Basic Books, New York.
48. Sabin, J.E. (1994). 'A credo for ethical managed care in mental health practice,' Hospital and Community Psychiatry 45, pp. 859-860.
49. Schneiderman, L.J. and Jecker, N.S. (1995). Wrong Medicine: Doctors, Patients, and Futile Treatment, Johns Hopkins University Press, Baltimore.
50. Vance, R. (1985). 'Medicine as dependent tradition: Historical and ethical reflections,' Perspectives in Biology and Medicine 28, pp. 282-302.
51. Veatch, R.M. (1981). A Theory of Medical Ethics, Basic Books, New York.
52. Veatch, R.M. (1991a). 'The concept of "medical indications,"' in The Patient-Physician Relation: The Patient as Partner, Part 2, Indiana University Press, Bloomington, pp. 54-62.
53. Veatch, R.M. (1991b). The Patient-Physician Relation: The Patient as Partner, Part 2, Indiana University Press, Bloomington.
54. Veatch, R.M. (1995). 'Abandoning informed consent,' Hastings Center Report 25(2), pp. 5-12.
55. Verghese, A. (1994). My Own Country: A Doctor's Story of a Town and its People in the Age of AIDS, Simon and Schuster, New York.
56. Ware, J.E., Brook, R.H., Rogers, W.H. et al. (1986). 'Comparison of health outcomes at a health maintenance organisation with those of fee-for-service care,' Lancet 1, pp. 1017-1022.
57. Ware, J.E., Bayliss, M.S., Rogers, W.H. et al. (1996). 'Differences in 4-year health outcomes for elderly and poor, chronically ill patients treated in HMO and fee-for-service systems,' Journal of the American Medical Association 276, pp. 1039-1047.
58. Zussman, R. (1992). Intensive Care: Medical Ethics and the Medical Profession, University of Chicago Press, Chicago.