Medicine, Money, and Morals
Oxford University Press Inc (Verlag)
978-0-19-509647-7 (ISBN)
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.
Marc A. Rodwin, Associate Professor of Law and Public Policy at Indiana University, Bloomington, has an M.A. from Oxford University, a J.D. from the University of Virginia Law School, and a Ph.D. from Brandeis University.
1. The Problem and the Profession's response: Physicians conflicts of interest; The medical profession's response ; 2. Current Problems and Institutional Responses: Incentives to increase services: The range of practices; The dangers of incentives to increase services and the ineffectiveness of current responses; Incentives to decrease services in HMOs and hospitals; The dangers of incentives to decrease services and the ineffectiveness of current responses; ; 3. Inferences for Policy: Fiduciary theory and the professions: Regulation of civil servants, business professionals and lawyers; What needs to be done? ; 4. Appendices
| Erscheint lt. Verlag | 11.5.1995 |
|---|---|
| Zusatzinfo | halftones, tables |
| Verlagsort | New York |
| Sprache | englisch |
| Maße | 220 x 136 mm |
| Gewicht | 535 g |
| Themenwelt | Medizin / Pharmazie ► Gesundheitswesen |
| Medizin / Pharmazie ► Medizinische Fachgebiete ► Medizinethik | |
| Studium ► Querschnittsbereiche ► Geschichte / Ethik der Medizin | |
| ISBN-10 | 0-19-509647-9 / 0195096479 |
| ISBN-13 | 978-0-19-509647-7 / 9780195096477 |
| Zustand | Neuware |
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