scholarly journals Ethical Impact of Changes in Health Care on the Role of Medicine in Society and the Physician - Patient Relationship

Author(s):  
Albert Simon

Patients contact a myriad of different health care personnel in their trek through the American health care system. In the 1950s on the numerous TV shows about medicine, it was easy to discern “who was who” in the health care cast of characters in these portrayals. The physicians, like Dr. Kildare, were always male, clean cut and serious looking. Nurses wore starched white dresses with nursing caps and distinctive pins; they instantly obeyed the doctor’s orders (including the one to make the doctor a cup of coffee). For better or worse it is a different world now than it was in the 1950s. Social role changes will soon have the doctors being mostly female and a large number of the nurses being male, no one wears a starched white dress, and any health care worker of any gender can have hair of any length, ear-rings and usually will be dressed in the generic scrub suit with white running shoes that has come to signify the American health care worker. Needless to say it is difficult to tell “who is who” in the health care system today by appearance. The stereotypical health care professional role identification related to dress is largely a thing of the past. So how do health care professionals distinguish themselves? Is it in roles, actions or responsibility?

1992 ◽  
Vol 18 (1-2) ◽  
pp. 73-96 ◽  
Author(s):  
David C. Hadorn

The structure and principal decision-making processes of the American health care system have, in recent years, evolved to closely resemble those of the legal-judicial system. This transformation reflects important common values that underlie both systems, including the values of life and liberty. This Article analyzes quasi-legal features of the health care system and draws conclusions about how those features might be used to address the problem of health care rationing. It concludes that coverage rules, if properly developed, can provide the sort of objective framework necessary to evaluate claims of health care needs. This Article also demonstrates that by defining legitimate health care needs, society can thereby potentially eliminate or forestall the need to ration necessary care. This can be achieved by using carefully developed coverage rules, rather than the informal rules currently in place, in conjunction with already existing due process methods for interpreting and implementing those rules.


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