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Departments of bioethics and medical
ethics are growing in prominence in many great American
universities. The unspoken reason for this new prominence is that,
in academic circles at least, there's widespread recognition that a
complete retooling of our health care system is badly needed.
And unless that retooling is guided by a set of ethical principles
(or, for utilitarian ethicists who don't believe in operating from
fixed principles, that the retooling is guided at least by a moral philosophy), then what we are
likely to get will be worse than what we have today.
That's certainly a frightening
thought.
We at YourDoctorintheFamily.com
are
by no means formally trained ethicists, but over the years one of us
(DrRich, of course) has had the audacity to engage prominent figures
in academic medicine and medical ethics in refereed public debates
over various ethical issues in health care. And so, as part of our
ongoing mission to help you understand and survive the health care
system, it's only fitting that we should find the audacity to discuss
issues related to bioethics.
We believe
that in order to reform our health care system in any equitable way,
that reform will need to be based on a set of ethical principles,
principles that must be agreed upon by our society (and not handed
down from on high). We propose such a set of ethical
principles for health care reform.
One reason
utilitarians don't like such ethical principles is that in real
life, different ethical principles are often in conflict.
That's what causes true ethical dilemmas. When it comes to
rationing health care, it turns out that two fundamental ethical
principles are nearly always in conflict - the principle of
maximizing fairness, and the principle of maximizing overall good.
You can't have both, and so you have an ethical dilemma. This is the fundamental dilemma that must be resolved in
order to formulate an equitable rationing system. Never shy, YourDoctorintheFamily.com
proposes
an ethical standard for
rationing that offers to resolve this dilemma.
When it
comes to rationing health care, the ethical precepts we adopt will
be vitally important. For when we must calculate which services
will be provided and which will not, those ethical
precepts will determine how we do the math.
We also
address ethical issues in
end-of-life care, and how those issues are colored by a
background of covert health care rationing.
Don't thank us. It's what we do.
We're your
on-line guide to understanding and
surviving the American health care system.
YourDoctorintheFamily.com
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