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Changing Economics and Clinical Ethical Decisionmaking: A View from the Trenches

Published online by Cambridge University Press:  01 April 2000

ERNLÉ W. D. YOUNG
Affiliation:
Ernlé W.D. Young, Ph.D., is Co-Director of the Stanford University Center for Biomedical Ethics, and Clinical Professor of Ethics in the Department of Medicine and Pediatrics, Stanford University School of Medicine

Abstract

There is good news, and there is bad news. The good news is that in my experience, younger physicians generally are much more concerned about the cost of clinical tests and treatments, and about justly distributing finite medical resources, than were those who practiced medicine in the fee-for-service era. The bad news has at least three components. First, with respect to medically nonbeneficial treatment in the ICU, managed care has not yet given evidence of wanting to put the brakes on unrealistic family demands for aggressive medical interventions. Second, managed care is frustrating many healthcare professionals as well as patients. And third, managed care has no apparent interest in addressing, and may even have contributed to, the problem of medical indigence. Let me develop these propositions more fully.

Type
PERSPECTIVES
Copyright
© 2000 Cambridge University Press

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