Over at The Covert Rationing Blog
He quotes a journal piece:
It is untenable for the medical profession to coninue asserting an idealistic ethic that is contradicted so openly in clinical practice. . .We propose that devotion to the best medical interests of each individual patient be replaced with an ethic of devotion to the best medical interests of the group [of patients] for which the physician is personally responsible.
from:Hall MA, Berenson RA. Ethical practice in managed care: a dose of realism. Ann Intern Med. 1998; 128:395-402.
This is a good example of how not having the patient paying for care allows ne forces the doctor to serve two masters in terms of ‘best medical interests’. Individuals are treated by physicians not groups.
The whole post is very worthwhile. He goes onto cite pioneering work by progressives to extend medical ethics to include
…a third ethcial precept: The Principle of Social Justice.
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