Bluffing, Puffing and Spinning in Managed-Care Organizations
Journal of Medicine and Philosophy. 2000 Feb; 25(1): 62-76.
I argue that because bluffing, puffing, and spinning are features of corporate life, they are likely to characterize the doctor-patient relationship in managed care medicine. I show that managed-care organizations (MCOs) and the physicians who contract with them make liberal use of puffing and spinning. In this way, they create a context in which it is likely that patients will also use deceptive mechanisms. Unfortunately, patients risk their health when they deceive their doctors. Using the warranty theory of truth I argue that although bluffing may be ethical in business because all participants agree to it and business has not warranted truth-telling, it is not ethical in a medical context because physicians and MCOs have warranted truth-telling and the quality of medical care depends on it.
Advertising; Business Ethics; Conflict of Interest; Deception; Diagnosis; Disclosure; Doctors; Economics; Ethics; Guidelines; Health; Health Insurance; Health Insurance Reimbursement; Incentives; Institutional Ethics; Insurance; Life; Managed Care Programs; Medicine; Motivation; Managed Care; Organizations; Patient Advocacy; Patients; Physician Patient Relationship; Physicians; Practice Guidelines; Resource Allocation; Risk; Trust; Withholding Treatment;
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