Fiscal Scarcity: Challenging Fidelity
While recognizing that all these economic changes will profoundly affect health care, many physicians and bioethicists insist that physicians can and should avoid directly compromising their patients’ welfare in the name of raising revenues or even containing costs. “Physicians are required to do everything they believe may benefit each patient without regard to costs or other societal considerations”1; “asking physicians to be cost-conscious … would be asking them to abandon their central commitment to their patients.”2 While the physician might assist in creating public or institutional resource policies, and while he occasionally must ration, as where there are too many patients for too few intensive care beds, on this traditional view he must never voluntarily say ‘no’ to his own patient simply in order to honor third parties’ economic concerns.
KeywordsEfficiency Protocol Special Obligation Indigent Patient Spending Decision Clinical Authority
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