This volume explores the impact of various health-care structures on the ability of health-care professionals to practice in an ethically acceptable manner. The limits of ethical possibility are created by the system within which health-care workers must practice: a system which mandates 'getting to know your patient' but at the same time is restricted by financial concerns of a hospital, hospice, or a health management organization. This juxtaposition of the two conflicting concerns of a health-care worker is discussed in this volume. Among the issues addressed are: Is it possible to appreciate patients' goals and values within a system that mandates that only a short time be spent with each patient? Ethical issues raised in a system where patients are treated by different physicians inside and outside the hospital; Health-care ethics which deal with the concerns of those with access to care but are not concerned with the needs of those who lack access to care. This volume will be of interest to health-care ethicists, as well as health-care professionals.
1. Health Care Systems and Ethics; E.H. Loewy. 2. Facing Finitude in Health; L.R. Churchill. 3. Health Care as a Right; E.-H.W. Kluge. 4. The Oregon Health Plan Ten Years Later; M.J. Garland. 5. A Mortgage on the House of God; P.A. Pugno. 6. Values in Medicine; F.T. Fitzgerald. 7. Generational Conflicts and their Impact on Thinking about the Healthcare System; R. Gronemeyer. 8. The Uninsured and the Rationing of Health Care; D. Chinitz, A. Israeli. 9. Application and Implications of Deontology, Utilitarianism and Pragmatism for Medical Practice; T. Cornelius. 10. The Old Ethics and the New Economics of Health Care; B. Rich. 11. Playing the HMO Language Game; R.Springer Loewy, E.H. Loewy. 12. Rationing Health Care in the United States and Canada; W. Glannon. 13. Altering Capitation to Reduce the Incentive to Undertreat Patients Inappropriately; R. Jaffe. 14. Cross Cultural Issues in Medicine; J.K. Park. 15. Competing Interests in Pediatric Managed Care Settings; S.E. Zinner-Kemp. Index.