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Medicine, money, and morals: physicians' conflicts of interest

New York: Oxford University Press (1993)

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  1. The Role of the Courts in Shaping Health Policy: An Empirical Analysis.Peter D. Jacobson, Elizabeth Selvin & Scott D. Pomfret - 2001 - Journal of Law, Medicine and Ethics 29 (3-4):278-289.
    The transformation of health-care delivery from fee-for-service medicine to managed care represents a fundamental philosophical shift away from the prevailing medical ethos that the needs of the individual patient take precedence over competing social values, such as reducing health-care costs. In managed care, financial incentives to reduce health-care utilization may result in denying an individual’s claim for medical services.Litigation challenging managed care’s resource allocation decisions often presents the need to resolve conflicting social policy goals, such as the tension between an (...)
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  • Mindful practice and the tacit ethics of the moment.Ronald M. Epstein - 2006 - Advances in Bioethics 10:115-144.
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  • Commentary: A Physician's Perspective on Conflicts of Interest.Kate T. Christensen - 1997 - Journal of Law, Medicine and Ethics 25 (2-3):199-201.
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  • Character formation in professional education: a word of caution.Robert M. Veatch - 2006 - Advances in Bioethics 10:29-45.
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  • (1 other version)Response to Daniel Callahan--better ways of rationing.R. W. Hunt - 1994 - Journal of Medical Ethics 20 (1):53-54.
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  • An ethics discussion series for hospital administrators.Allan S. Brett, James I. Raymond, Donald E. Saunders & George Khushf - 1998 - HEC Forum 10 (2):177-185.
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  • Off with Their Heads: The Need to Criminalize Some Forms of Scientific Misconduct.Barbara K. Redman & Arthur L. Caplan - 2005 - Journal of Law, Medicine and Ethics 33 (2):345-348.
    An increasingly long line of high-profile scientific misconduct cases raises the question of whether regulatory policy ought to incorporate more rigorous sanctions for investigators and their institutions. Broad and Wade graphically describe these cases through the early 1980s. They continue to recent times with the cases of Evan Dreyer, Kimon Angelides and Robert Liburdy, Justin Radolf, and others. In addition, recent Congressional investigation into conflict of interest concerns surrounding consulting by National Institutes of Health scientists has raised further questions about (...)
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  • Teaching Conflict: Professionalism and Medical Education.K. J. Holloway - 2015 - Journal of Bioethical Inquiry 12 (4):675-685.
    Resistance by physicians, medical researchers, medical educators, and medical students to pharmaceutical industry influence in medicine is often based on the notion that physicians and the industry are in conflict. This criticism has taken the form of a professional movement opposing conflict of interest in medicine and medical education and has resulted in policies and guidelines that frame COI as the problem and outline measures to address this problem. In this paper, I offer a critique of this focus on COI (...)
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  • Conflict of interests, vested interests and health research.Miles Little - 2000 - Journal of Evaluation in Clinical Practice 6 (4):413-420.
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  • An agenda for future debate on concepts of health and disease.George Khushf - 2007 - Medicine, Health Care and Philosophy 10 (1):19-27.
    The traditional contrast between naturalist and normativist disease concepts fails to capture the most salient features of the health concepts debate. By using health concepts as a window on background notions of medical science and ethics, I show how Christopher Boorse (an influential naturalist) and Lennart Nordenfelt (an influential normativist) actually share deep assumptions about the character of medicine. Their disease concepts attempt, in different ways, to shore up the same medical model. For both, health concepts function like demarcation criteria (...)
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  • The Metamorphosis of Managed Care: Implications for Health Reform Internationally.Marc A. Rodwin - 2010 - Journal of Law, Medicine and Ethics 38 (2):352-364.
    Many writers suggest that managed care had a brief life and that we are now in a post-managed care era. Yet managed care has had a long history and continues to thrive. Writers also often assume that managed care is a fixed entity, or focus on its tools, rather than the context in which it operates and the functions it performs. They overlook that managed care has evolved and neglect to examine the role that it plays in the health system.This (...)
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  • Beyond Money: Conscientious Objection in Medicine as a Conflict of Interests.Alberto Giubilini & Julian Savulescu - 2020 - Journal of Bioethical Inquiry 17 (2):229-243.
    Conflict of interests in medicine are typically taken to be financial in nature: it is often assumed that a COI occurs when a healthcare practitioner’s financial interest conflicts with patients’ interests, public health interests, or professional obligations more generally. Even when non-financial COIs are acknowledged, ethical concerns are almost exclusively reserved for financial COIs. However, the notion of “interests” cannot be reduced to its financial component. Individuals in general, and medical professionals in particular, have different types of interests, many of (...)
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  • After Conflicts of Interest: From Procedural Short-Cut to Ethico-Political Debate.Christopher Mayes - 2020 - Journal of Bioethical Inquiry 17 (2):245-255.
    This paper critically examines the proliferation of conflicts of interest discourse and how the most common conceptions of COI presuppose a hierarchy of primary and secondary interests. I show that a form of professional virtue or duty is commonly employed to give the primary interest normative force. However, I argue that in the context of increasingly commercialized healthcare neither virtue nor duty can do the normative work expected of them. Furthermore, I suggest that COI discourse is symptom of rather than (...)
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  • Conflicts of Interest, Institutional Corruption, and Pharma: An Agenda for Reform.Marc A. Rodwin - 2012 - Journal of Law, Medicine and Ethics 40 (3):511-522.
    Why do physicians have financial conflicts of interest? They arise because society expects physicians to act in their patients’ interest, while simultaneously, financial incentives encourage physicians to practice medicine in ways that promote their own interests or those of third parties. Because physicians’ clinical choices, referrals, and prescriptions affect the fortune of third parties, these third parties may offer physicians financial incentives to make income-driven clinical choices. In the past, physicians and scholars typically conceived of conflicts of interest as an (...)
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  • The Ethics and Governance of Medical Research: What does regulation have to do with morality?Richard Ashcroft - 2003 - New Review of Bioethics 1 (1):41-58.
    (2003). The Ethics and Governance of Medical Research: What does regulation have to do with morality? New Review of Bioethics: Vol. 1, No. 1, pp. 41-58.
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  • Physician entrepreneurs, self-referral, and conflicts of interest: An overview. [REVIEW]David M. Zientek - 2003 - HEC Forum 15 (2):111-133.
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  • A market of distrust: toward a cultural sociology of unofficial exchanges between patients and doctors in China.Cheris Shun-Ching Chan & Zelin Yao - 2018 - Theory and Society 47 (6):737-772.
    This article examines how distrust drives exchange. We propose a theoretical framework integrating the literature of trust into cultural sociology and use a case of patients giving hongbao (red envelopes containing money) to doctors in China to examine how distrust drives different forms of unofficial exchange. Based on more than two years’ ethnography, we found that hongbao exchanges between Chinese patients and doctors were, ironically, bred by the public’s generalized distrust in doctors’ moral ethics. In the absence of institutional assurance, (...)
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  • Ethically Important Distinctions among Managed Care Organizations.Kate T. Christensen - 1995 - Journal of Law, Medicine and Ethics 23 (3):223-229.
    Due to society's need to control health care costs and to the failure of legislated health care reform, managed care is expanding at a rapid rate and will soon be the predominate form of health care delivery. Plans by Congress to bring Medicare and Medicaid under managed care will further consolidate this trend. Barring some legislative fiat, managed care is here to stay.The term managed care describes a diverse set of organizational forms. Wide variations in approach, financing, physician involvement, and (...)
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  • Business vs. Medical Ethics: Conflicting Standards for Managed Care.Wendy K. Mariner - 1995 - Journal of Law, Medicine and Ethics 23 (3):236-246.
    The increased competition for a share of the market of insured patients, which arose in the wake of failed comprehensive health care reform, has provoked questions about what, if any, standards will govern new “competitive” health care organizations. Managed care arrangements, which typically shift to providers and patients some or all of the financial risk for patient care, are of special concern because they can create incentives to withhold beneficial care from patients. Of course, fee-for-service medical practice creates incentives to (...)
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  • Environmental Factors Contributing to Wrongdoing in Medicine: A Criterion-Based Review of Studies and Cases.James M. DuBois, Emily E. Anderson, Kelly Carroll, Tyler Gibb, Elena Kraus, Timothy Rubbelke & Meghan Vasher - 2012 - Ethics and Behavior 22 (3):163 - 188.
    In this article we describe our approach to understanding wrongdoing in medical research and practice, which involves the statistical analysis of coded data from a large set of published cases. We focus on understanding the environmental factors that predict the kind and the severity of wrongdoing in medicine. Through review of empirical and theoretical literature, consultation with experts, the application of criminological theory, and ongoing analysis of our first 60 cases, we hypothesize that 10 contextual features of the medical environment (...)
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  • Challenging the Idea of Corporate Responsibility: Physician's Obligation to Disclose Information.Luca Chiapperino & Janaina Oliva Oishi - 2011 - American Journal of Bioethics 11 (9):20-21.
    The American Journal of Bioethics, Volume 11, Issue 9, Page 20-21, September 2011.
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  • A role for stakeholder ethics in meeting the ethical challenges posed by managed-care organizations.Patricia Illingworth - 1999 - HEC Forum 11 (4):306-322.
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  • How did physician ownership become a federal case? The Stark amendments and their prospects.Sarah M. Stout & David C. Warner - 2003 - HEC Forum 15 (2):171-187.
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  • On the fragility of medical virtue in a neoliberal context: the case of commercial conflicts of interest in reproductive medicine.Christopher Mayes, Brette Blakely, Ian Kerridge, Paul Komesaroff, Ian Olver & Wendy Lipworth - 2016 - Theoretical Medicine and Bioethics 37 (1):97-111.
    Social, political, and economic environments play an active role in nurturing professional virtue. Yet, these environments can also lead to the erosion of virtue. As such, professional virtue is fragile and vulnerable to environmental shifts. While physicians are often considered to be among the most virtuous of professional groups, concern has also always existed about the impact of commercial arrangements on physicians’ willingness and capacity to enact their professional virtues. This article examines the ways in which commercial arrangements have been (...)
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  • (1 other version)Response to Callahan, Daniel-better ways of rationing.Rw Hunt - 1994 - Journal of Medical Ethics 20 (1):53-54.
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  • Health Professionals “Make Their Choice”: Pharmaceutical Industry Leaders’ Understandings of Conflict of Interest.Quinn Grundy, Lisa Tierney, Christopher Mayes & Wendy Lipworth - 2017 - Journal of Bioethical Inquiry 14 (4):541-553.
    Conflicts of interest, stemming from relationships between health professionals and the pharmaceutical industry, remain a highly divisive and inflammatory issue in healthcare. Given that most jurisdictions rely on industry to self-regulate with respect to its interactions with health professionals, it is surprising that little research has explored industry leaders’ understandings of conflicts of interest. Drawing from in-depth interviews with ten pharmaceutical industry leaders based in Australia, we explore the normalized and structural management of conflicts of interest within pharmaceutical companies. We (...)
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  • The Aesthetics of Clinical Judgment: Exploring the Link between Diagnostic Elegance and Effective Resource Utilization.George Khushf - 1999 - Medicine, Health Care and Philosophy 2 (2):141-159.
    Many physicians assert that new cost-control mechanisms inappropriately interfere with clinical decision-making. They claim that high costs arise from poorly practiced medicine, and argue that effective utilization of resources is best promoted by advancing the scientific and ethical ideals of medicine. However, the claim is not warranted by empirical evidence. In this essay, I show how it rests upon aesthetic considerations associated with diagnostic elegance. I first consider scientific rationality generally. After a review of analytical empiricist and socio-historical approaches in (...)
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  • Reviews. [REVIEW]Henry H. Bauer, Carlos S. Alvarado, Bryan J. Williams, Constantin Cranganu, Hannah Jenkins, Michael Davidson, Mark Rodeghier, Karl P. N. Shuker, Michael Nahm, Wellington Zangari, Fatima Regina Machado & Patric Giesler - 2011 - Journal of Scientific Exploration 25 (2).
    Essay Review: Medicine To Make You Mad Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America by Robert Whitaker Henry H. Bauer Essay Review: Apparitions of the Living: The Views of William H. Harrison and Gabriel Delanne Spirits Before Our Eyes by William H. Harrison Les Apparitions Matérialisées des Vivants & des Morts. Vol. 1: Les Fantômes de Vivants [Materialized Apparitions of the Living and of the Dead. Vol. 1: Phantoms of the (...)
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