_BMC Medical Ethics_ is an open access journal publishing original peer-reviewed research articles in relation to the ethical aspects of biomedical research and clinical practice, including professional choices and conduct, medical technologies, healthcare systems and health policies. _BMC __Medical Ethics _is part of the _BMC_ series which publishes subject-specific journals focused on the needs of individual research communities across all areas of biology and medicine. We do not make editorial decisions on the basis of the interest of a study or (...) its likely impact. Studies must be scientifically valid; for research articles this includes a scientifically sound research question, the use of suitable methods and analysis, and following community-agreed standards relevant to the research field. Specific criteria for other article types can be found in the submission guidelines. _BMC series - open, inclusive and trusted_. (shrink)

A growing number of professional associations and occupational groups are creating codes of ethics with the goal of guiding their members, protecting service users, and safeguarding the reputation of the profession. There is a great deal of literature dealing with the question to what extent ethical codes can achieve their desired objectives. The present paper does not contribute to this debate. Its aim is rather to investigate how rational it is to comply with codes of conduct. It is natural and (...) virtually inevitable for a reflective person to ask why one should pay any attention to ethical codes, in particular if following a code is not in one’s own interest. In order to achieve the aim of this paper, I shall (in “Quasi-reasons for complying with an ethical code” section) discuss reasons that only appear to be reasons for complying with a code. In “Code-independent reasons” section, I shall present genuine practical reasons that, however, turn out to be reasons of the wrong kind. In “Code-dependent reasons” section finally presents the most important reasons for complying with ethical codes. The paper argues that while ethical codes do not necessarily yield reasons for action, professionals can have genuine reasons for complying with a code, which may, however, be rather weak and easily overridden by reasons for deviating from the code. (shrink)

The paper begins by tracing the historical development of American medicine as practice, profession, and industry from the eighteenth century to the present. This historical outline emphasizes shifting conceptions of physicians and physician ethics. It lays the basis for showing, in the second section, how contemporary controversies about the physician’s role in managed care take root in medicine’s past. In the final two sections, I revisit both the historical analysis and its application to contemporary debates. I argue that historical narratives (...) can function as “master narratives” that suppress or leave out historical facts. I bring to the surface what is covered up by the master narrative approach, and show its relevance to contemporary ethical debates. I conclude by proposing that preserving the integrity of medicine will require modifying the master narratives we tell about physicians. The integrity of medicine also offers new perspectives for thinking about managed care and the broader topic of health care reform. (shrink)