The American health care system is undergoing drastic changes, most notably the advent and subsequent expansion of managed care organizations. Health care professionals agree that the process of merging managed care and health care delivery, two potentially conflicting systems, has resulted in a number of ethical conflicts. To some degree, such ethical conflicts are rooted in the structure of today's managed care environment itself. This environment is primarily driven by for-profit and investor-owned entities, and too often, fiscal constraints and cost cutting can create ethical problems. One particularly troubling development is the unintentional withholding of relevant information patients would need to make competent and independent choices about their medical treatment. Considered a fundamental right, the doctrine of informed consent requires health care providers to disclose to their patients the nature of procedures to be performed and the attendant risks, benefits, and alternatives. This presentation explores the ethical ramifications inherent in the right of patients to informed consent. It identifies two fundamental concepts that establish the basis for informed consent: the fiduciary relationship between provider and patient, incorporating honesty, trust, and mutual respect, and patient autonomy, or the patient's right to self-determination. Preconditions for informed consent (i.e., voluntariness, elements of disclosure, and competence or understanding) are discussed. Recommendations for creating an "ethically aware" managed care environment that encourages the delivery of high quality health services while preventing the erosion of informed consent in the name of efficiency are reviewed.
Learning Objectives: At the conclusion of the presentation, participants should be able to recognize the ethical ramifications inherent in the right of patients to informed consent and identify possible strategies for encouraging the delivery of quality health care services in today's complex managed care environment.
Keywords: Managed Care, Ethics
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.