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dc.creatorKhushf, Georgeen
dc.date.accessioned2015-05-05T19:01:21Zen
dc.date.available2015-05-05T19:01:21Zen
dc.date.created1998-02en
dc.date.issued1998-02en
dc.identifier10.1076/jmep.23.1.98.2591en
dc.identifier.bibliographicCitationJournal of Medicine and Philosophy. 1998 Feb; 23(1): 98-122.en
dc.identifier.issn0360-5310en
dc.identifier.urihttp://worldcatlibraries.org/registry/gateway?version=1.0&url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&atitle=A+Radical+Rupture+in+the+Paradigm+of+Modern+Medicine:+Conflicts+Of+interest,+Fiduciary+Obligations,+and+the+Scientific+Ideal.+&title=Journal+of+Medicine+and+Philosophy.++&volume=23&issue=1&pages=98-122&date=1998&au=Khushf,+Georgeen
dc.identifier.urihttp://dx.doi.org/10.1076/jmep.23.1.98.2591en
dc.identifier.urihttp://hdl.handle.net/10822/752472en
dc.description.abstractConflicts of interest serve as a cipher for a radical rupture in the Flexnerian paradigm of medicine, and they can only be addressed if we recognize that health care is now practiced by institutions, not just individual physicians. By showing how "appropriate utilization of services" or "that which is medically indicated" is a function of socioeconomic factors related to institutional responsibilities, I point toward an administrative and organizational ethic as a needed component for addressing conflicts of interest. The argument is developed by reviewing three important books. First, I consider Mark Rodwin's attempt to configure the economic structures of medicine so that classical fiduciary and scientific ideals can be fostered. Second, I consider E. Haavi Morreim's attempt to modify the classical ideals in order to account for new economic realities. Finally, by considering essays in a recent volume on conflicts of interest edited by Spece, Shimm, and Buchanan, I argue for a constructive dialectic between the approaches of Rodwin and Morreim. In order to properly address conflicts of interest, there must be a radical reassessment of medicine that accounts for the interrelation between scientific, ethical, and economic concerns. Until institutions come into view and professional ethics is developed to account for their role, legitimate interests and obligations of diverse parties cannot be harmonized.en
dc.formatArticleen
dc.languageenen
dc.sourceBRL:MEDKIE/98216476en
dc.subjectAccountabilityen
dc.subjectBioethicsen
dc.subjectCommon Gooden
dc.subjectConflict of Interesten
dc.subjectDecision Makingen
dc.subjectDisclosureen
dc.subjectDiseaseen
dc.subjectEconomicsen
dc.subjectEntrepreneurshipen
dc.subjectEthicsen
dc.subjectGovernmenten
dc.subjectGovernment Regulationen
dc.subjectHealthen
dc.subjectHealth Careen
dc.subjectHealth Care Deliveryen
dc.subjectHealth Insuranceen
dc.subjectHealth Servicesen
dc.subjectHealth Services Misuseen
dc.subjectHospitalsen
dc.subjectIatrogenic Diseaseen
dc.subjectIncentivesen
dc.subjectInstitutional Ethicsen
dc.subjectInsuranceen
dc.subjectManaged Care Programsen
dc.subjectMedical Ethicsen
dc.subjectMedicineen
dc.subjectManaged Careen
dc.subjectObligations to Societyen
dc.subjectOrganizationsen
dc.subjectPatient Advocacyen
dc.subjectPatientsen
dc.subjectPhysiciansen
dc.subjectProfessional Ethicsen
dc.subjectProfessional Organizationsen
dc.subjectRegulationen
dc.subjectRemunerationen
dc.subjectResearchen
dc.subjectResource Allocationen
dc.subjectResponsibilitiesen
dc.subjectScarcityen
dc.subjectSelf Regulationen
dc.subjectSocioeconomic Factorsen
dc.subjectSurgeryen
dc.titleA Radical Rupture in the Paradigm of Modern Medicine: Conflicts of Interest, Fiduciary Obligations, and the Scientific Idealen
dc.provenanceDigital citation created by the National Reference Center for Bioethics Literature at Georgetown University for the BIOETHICSLINE database, part of the Kennedy Institute of Ethics' Bioethics Information Retrieval Project funded by the United States National Library of Medicine.en
dc.provenanceDigital citation migrated from OpenText LiveLink Discovery Server database named NBIO hosted by the Bioethics Research Library to the DSpace collection BioethicsLine hosted by Georgetown University.en


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