The hegemony of money: Commercialism and professionalism in American medicine

Cambridge Quarterly of Healthcare Ethics

Volumn 16, Issue 4, 2007, Pages 407-414

  Churchill, Larry R ^a  

^a NONE

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; COMMERCIAL PHENOMENA; COMMODIFICATION; ECONOMICS; ETHICS; FINANCIAL MANAGEMENT; HEALTH CARE COST; HEALTH CARE DELIVERY; HEALTH ECONOMICS; HEALTH PERSONNEL ATTITUDE; HUMAN; MEDICAL ETHICS; MEDICAL PROFESSION; PHYSICIAN; PHYSICIAN ATTITUDE; SOCIAL PSYCHOLOGY; UNITED STATES;

ATTITUDE OF HEALTH PERSONNEL; COMMERCE; COMMODIFICATION; DELIVERY OF HEALTH CARE; ECONOMICS, MEDICAL; ENTREPRENEURSHIP; ETHICS, MEDICAL; HEALTH CARE SECTOR; HEALTH OCCUPATIONS; HUMANS; MARKETING OF HEALTH SERVICES; PHYSICIAN'S ROLE; PHYSICIANS; SOCIAL VALUES; UNITED STATES;

EID: 34547956490     PISSN: 09631801     EISSN: 14692147     Source Type: Journal    
DOI: 10.1017/S0963180107070508     Document Type: Article

References (22)

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2. For an excellent edition of Gramsci's work, see Hoare Q, Smith GN, eds. Selections from the Prison Notebooks. London: Lawrence and Wishart; 1971.
3. For an exposition of the importance of Gramsci's thought for culture and society see Crehan K. Gramsci, Culture and Anthropology. London: Pluto Press; 2002. Crehan claims that "hegemony" should be defined as the (often implicit) consent given to the powerful organizing forces of society, as opposed to the coercive power exercised by the police power of the state. See 102-4ff.
4. Angell M. The Truth about the Drug Companies: How They Deceive Us and What to Do about It. New York: Random House; 2004.
5. Kassirer J. On The Take: How Medicine's Complicity with Big Business Can Endanger Your Health. New York: Oxford University Press; 2005.
6. Kant I. Foundations of the Metaphysics of Morals. Beck LW, trans. New York: Macmillan; 1985:53ff.
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8. See Smith's An Inquiry into the Nature and Causes of the Wealth of Nations, Vol. 1. Campbell RH, Skinner AS, eds. Oxford: Clarendon Press; 1976:26-7, 456ff. The "invisible hand," which affects social benefits from pursuit of self-interest, is also a motif of Smith's earlier writings.
9. See The Theory of Moral Sentiments, Raphael DD, Macfie AL, eds. Indianapolis: Liberty Classics; 1982:184-5.
10. For an excellent historical contextualization of Smith's work and its applicability to modern societies, see Mueller JZ. Adam Smith in His Time and Ours: Designing the Decent Society. New York: The Free Press; 1993.
11. Kuttner R. Everything for Sale: The Virtues and Limits of Markets. New York: Alfred A. Knopf; 1997:39-67.
12. de Botton A. Status Anxiety. New York: Pantheon Books; 2004.
13. See note 10, de Botton 2004:59.
14. See note 10, de Botton 2004:65.
15. Weber M. The Protestant Ethic and the Spirit of Capitalism, Parsons T, trans. New York: Charles Scribner's Sons; 1958. This was first published as a two-part article in 1904-1905.
16. See note 10, de Botton 2004, at p. 71.
17. Berger J. Ways of Seeing. London: Penguin; 1972:149.
18. Material for this section was adapted from Churchill LR. The United States health care system under managed care: How the commodification of health care distorts ethics and threatens equity. Health Care Analysis 1999;7(4):393-411.
19. The phrase is Thorstein Veblen's, coined in 1899 in his The Theory of the Leisure Class. New York: Dover; 1994.
20. The Oxford English Dictionary provides some interesting etymological senses of "profession" that are helpful here.
21. Sullivan W. What is left of professionalism after managed care? The Hastings Center Report 1999;29:7-13. If further evidence if needed for the demise of the public confidence in physicians as professionals, a recent survey by the American College of Physicians indicated that in terms of being respected and admired, physicians now rate fifth, behind druggists and grade-school teachers, and that 9 out of 10 physician leaders surveyed (from a pool of over 1400), were either "very concerned" or "moderately concerned" about unethical business practices tainting healthcare.
22. See Romano M. Perception, is everything. Modern Healthcare 2005;35:6-7,16.