Cancer, Managed Care, and Therapeutic Research: An Ethicist's View
Sulmasy, Daniel P.
HMO Practice. 1997 Jun; 11(2): 59-62.
The question of whether HMOs should pay for therapeutic oncological research is an important moral question. Simply declaring that a protocol is experimental does not imply that an HMO has no obligation to underwrite the care. On the other hand, the "technological imperative", which states that care should be delivered simply because it is new and technologically advanced is also a false moral premise. HMOs and clinical investigators must both acknowledge that they have competing moral obligations that are sometimes in conflict. They should also accept the formal principle of justice that similars should be treated similarly. If the competing obligations are carefully ranked, it is possible to craft a proposal that meets the criterion of formal justice and simultaneously satisfies all the competing moral obligations. It is suggested that such a proposal would include payment by the HMO for a fraction of care proportionate to the therapeutic motive of the treatment, but that HMOs would also contribute to an all-payer pool to help support therapeutic research. If this, or similar proposals are not considered, the issue will be settled in the courts in a manner that will be detrimental to the nation as a whole.
Cancer; Common Good; Clinical Investigators; Economics; Ethics; Government; Government Financing; Health; Health Care; Health Insurance; Health Maintenance Organizations; Hospitals; Human Experimentation; Institutional Ethics; Insurance; Investigators; Justice; Moral Obligations; Moral Policy; Managed Care; Organizations; Patient Advocacy; Peer Review; Physicians; Research; Research Institutes; Review; Selection of Subjects; Therapeutic Research;
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Povar, Gail J.; Blumen, Helen; Daniel, John; Daub, Suzanne; Evans, Lois; Holm, Richard P.; Levkovich, Natalie; McCarter, Alice O.; Sabin, James; Snyder, Lois; Sulmasy, Daniel; Vaughan, Peter; Wellikson, Laurence D.; Campbell, Amy (2004-07-20)Cost pressures and changes in the health care environment pose ethical challenges and hard choices for patients, physicians, policymakers, and society. In 2000 and 2001, the American College of Physicians, with the Harvard ...
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