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Changing Health Care Systems from Ethical, Economic, and Cross Cultural Perspectives

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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 patient's 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; and 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 should be of interest to health-care ethicists, as well as health-care professionals.

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Contents
1. Health Care Systems and Ethics ERICHH. LOEWY
2. Facing Finitude in Health LARRYR. CHURCHILL
3. Health Care as a Right EIKE-HENNERW. KLUGE
4. The Oregon Health Plan Ten Years Later MICHAELJ. GARLAND
5.A Mortgage on the House of God PERRYA. PUGNO
6.Values in Medicine FAITHT. FITZGERALD
7. Generational Conflicts and their Impact on Thinking about the Healthcare System REIMERGRONEMEYER
8. The Uninsured and the Rationing of Health Care DAVIDCHINITZANDAVIISRAELI
xv
1
15
29
49
63
71
77
85
xvi
9. Application and Implications of Deontology, Utilitarianism, and Pragmatism for Medical Practice THOR CORNELIUS
10. The Old Ethics and the NewEconomics of Health Care BENRICH
1 1. Playing the HMO Language Game ROBERTASPRINGERLOEWYANDERICHH. LOEWY
12. Rationing Health Care in the United States and Canada WALTERGLANNON
13. Altering Capitation to Reduce the Incentive to Undertreat Patients Inappropriately RORYJAFFE
14. Cross Cultural Issues in Medicine JEANNYK. PARK
15. Competing Interests in Pediatric Managed Care Settings SUSANE. ZINNER-KEMP
Index
Contents
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127
143
151
163
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181