Quality Medical Care

In the past half-century an extraordinarily generous, uncritical reimbursement system has empowered physicians to define and deliver tonus that is interventionist and highly technological. Longstanding ethical precepts hold that physicians atomic number 18 liable for their patients, and modern economic arrangements pick up encouraged physicians to focus on their patients' welf atomic number 18, virtu eachy to the exclusion of be or other competing considerations. provide by these economic and ethical factors, in turn, tort natural law has empowered the medical profession to define timbre for sub judice purposes to set the standard of care and has required physicians to deliver a roughly uniform standard to all patients, essentially regardless of cost.

Recent economic changes now force reconsideration of this pattern. Arguably, physicians' enactment to deliver a lavish, highly interventionist quality of care is no longer economically sustainable, medically justifiable, ethically acceptable, or de jure defensible. As third parties exert greater control everywhere strained resources, it is no longer possible or credible for physicians to command resources with just a signature. And as people who let been excluded from the heal

Second, once patients consider which interventions are worth their cost, there is commensurately less need for third-party utilization revaluation (UR) to do it for them.(96) Reducing UR also saves on administrative costs and limits intrusions into the physician-patient relationship. Similarly, where patients have a personal reason to ensure that their bills are fair and accurate, perhaps employers will not have to grant patients to do such checking.(97)

More fundamentally, the problem is that courts still wear physicians to commandeer other people's money and property on behalf of their patients. That is, the quality of care required under tort law oft includes resources that are neither owned, nor either longer even controlled, by the physician. Perhaps this problem will be ameliorated if and when the nation enacts planetary access to health care.

However, unless that plan not only mandates exactly successfully ensures equal care for all citizens a insurance fraught with hazard(44)--then the legal system will still have to recognize that physicians cannot deliver an equal standard of care to all patients, and that they cannot deliver resources that others own and control.

Contemporary bioethical literature emphasizes that patients should be see as autonomous beings by honoring their freedom to hold among medical interventions according to their own values. Informed choice is patients' right, notwithstanding is not ordinarily construed as a duty. Consistent with honest-to-god doctrines of medical ethics, bioethicists typically assume that physicians still bear the major responsibilities. They are obligated not only to offer recommendations to patients, save also to make even the most difficult decisions for any patients or families who did not wish to decide for themselves.(74) When difficult choices mustiness be made about continuing life-support, for instance, physicians have broadly speaking felt obligated to make them, sparing families from the terrible evil that could eventuate if they we
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