"[This book is] the most authoritative assessment of the advantages and disadvantages of recent trends toward the commercialization of health care," says Robert Pear of The New York Times. This major study by the Institute of Medicine examines virtually all aspects of for-profit health care in the United States, including the quality and availability of health care, the cost of medical care, access to financial capital, implications for education and research, and the fiduciary role of the physician. In addition to the report, the book contains 15 papers by experts in the field of for-profit health care covering a broad range of topicsâ€"from trends in the growth of major investor-owned hospital companies to the ethical issues in for-profit health care. "The report makes a lasting contribution to the health policy literature." â€"Journal of Health Politics, Policy and Law.

Marc A. Rodwin draws on his own experience as a health lawyer--and his research in health ethics, law, and policy--to reveal how financial conflicts of interest can and do negatively affect the quality of patient care. He shows that the problem has become worse over the last century and provides many actual examples of how doctors' decisions are influenced by financial considerations. We learn how two California physicians, for example, resumed referrals to Pasadena General Hospital only after the hospital started paying $70 per patient (their referrals grew from 14 in one month to 82 in the next). As Rodwin writes, incentives such as this can inhibit a doctor from taking action when a hospital fails to provide proper service, and may also lead to the unnecessary hospitalization of patients. We also learn of a Wyeth-Ayerst Labs promotion in which physicians who started patients on INDERAL (a drug for high blood pressure, angina, and migraines) received 1000 mileage points on American Airlines for each patient (studies show that promotions such as this have a direct effect on a doctor's choice of drug). Rodwin reveals why the medical community has failed to regulate conflicts of interest: peer review has little authority, state licensing boards are usually ignorant of abuses, and the AMA code of ethics has historically been recommended rather than required. He examines what can be learned from the way society has coped with the conflicts of interest of other professionals --lawyers, government officials, and businessmen--all of which are held to higher standards of accountability than doctors. And he recommends that efforts be made to prohibit and regulate certain kinds of activity (such as kickbacks and self-referrals), to monitor and regulate conduct, and to provide penalties for improper conduct. Our failure to face physicians' conflicts of interest has distorted the way medicine is practiced, compromised the loyalty of doctors to patients, and harmed society, the integrity of the medical profession, and patients. For those concerned with the quality of health care or medical ethics, Medicine, Money and Morals is a provocative look into the current health care crisis and a powerful prescription for change.

Medicine and Money: A Study of the Role of Beneficence in Health Care Cost Containment is a frank discussion of the moral problems associated with the need to control health care costs. The book provides a base for physicians to address these concerns and examines the events leading to America's current health care crisis, diminishing beneficence. After a brief definition of the problem, Frank H. Marsh and Mark Yarborough continue by describing the threat of cost containment and justifying beneficence-based health care system. Special importance is given to Medicine and Money by the lengthy suggestions on implementing beneficence in the health care system. Marsh and Yarborough address the problem of eroding morality and rising cost concerns of our present health care system. They argue that if the central role of beneficence is abandoned, the medical profession will be unable to properly meet the challenge it faces. Medicine and Money divides its argument into two sections. In the first section, the current crisis in health care is examined and a justification for beneficence is given. The second section describes how beneficence can be implemented in the health care system as a means to control health care costs. Medicine and Money is written for every member of the medical and philosophical communities.

In What Money Can't Buy, renowned political philosopher Michael J. Sandel rethinks the role that markets and money should play in our society. Should we pay children to read books or to get good grades? Should we put a price on human life to decide how much pollution to allow? Is it ethical to pay people to test risky new drugs or to donate their organs? What about hiring mercenaries to fight our wars, outsourcing inmates to for-profit prisons, auctioning admission to elite universities, or selling citizenship to immigrants willing to pay? In his New York Times bestseller What Money Can't Buy, Michael J. Sandel takes up one of the biggest ethical questions of our time: Isn't there something wrong with a world in which everything is for sale? If so, how can we prevent market values from reaching into spheres of life where they don't belong? What are the moral limits of markets? Over recent decades, market values have crowded out nonmarket norms in almost every aspect of life. Without quite realizing it, Sandel argues, we have drifted from having a market economy to being a market society. In Justice, an international bestseller, Sandel showed himself to be a master at illuminating, with clarity and verve, the hard moral questions we confront in our everyday lives. Now, in What Money Can't Buy, he provokes a debate that's been missing in our market-driven age: What is the proper role of markets in a democratic society, and how can we protect the moral and civic goods that markets do not honor and money cannot buy?

Medicine, morals and money have, for centuries, lived in uneasy cohabitation. Dwelling in the social institution of care of the sick, each needs the other, yet each is embarrassed to admit the other's presence. Morality, in particular, suffers embarrassment, for it is often required to explain how money and medicine are not inimical. Throughout the history of Western medicine, morality's explanations have been con sistently ambiguous. Pla.o held that the physician must cultivate the art of getting paid as well as the art of healing, for even if the goal of medicine is healing and not making money, the self-interest of the craftsman is satisfied thereby [4]. Centuries later, a medieval medical moralist, Henri de Mandeville, said: "The chief object of the patient ... is to get cured ... the object of the surgeon, on the other hand, is to obtain his money ... ([5], p. 16). This incompatibility, while general, is not universal. Throughout history, medical practitioners have resolved the problem - either in conscience or to their satisfaction. Some physicians have been so reluctant to make a profit from the ills of those whom they treated that they preferred to live in poverty. Samuel Johnson described his friend, Dr. Robert Levet, a Practiser of Physic: No summons mock'd by chill delay, No petty gain disdain'd by pride; The modest wants of ev'ry day The toil of ev'ry day supplied [3].

Medicine's changing economics have already fundamentally, permanently altered the relationship between physician and patient, E. Haavi Morreim argues. Physicians must weigh a patient's interests against the legitimate, competing claims of other patients, of payers, of society as a whole, and sometimes even of the physician himself. Focusing on actual situations in the clinical setting, Morreim explores the complex moral problems that current economic realities pose for the practicing physician. She redefines the moral obligations of both physicians and patients, traces the specific effects of these redefined obligations on clinical practice, and explores the implications for patients as individuals and for national health policy. Although the book focuses on health care in the United States, physicians everywhere are likely to face many of the same basic issues of clinical ethics, because every system of health care financing and distribution today is constrained by finite resources.

The first book to comprehensively address private equity and health care, Ethically Challenged raises the curtain on an industry notorious for its secrecy, exposing the nefarious side of its maneuvers.

Should organ transplants be given to patients who have waited the longest, or need it most urgently, or those whose survival prospects are the best? The rationing of health care is universal and inevitable, taking place in poor and affluent countries, in publicly funded and private health care systems. Someone must budget for as well as dispense health care whilst aging populations severely stretch the availability of resources. The Ethics of Health Care Rationing is a clear and much-needed introduction to this increasingly important topic, considering and assessing the major ethical problems and dilemmas about the allocation, scarcity and rationing of health care. Beginning with a helpful overview of why rationing is an ethical problem, the authors examine the following key topics: What is the value of health? How can it be measured? What does it mean that a treatment is "good value for money"? What sort of distributive principles - utilitarian, egalitarian or prioritarian - should we rely on when thinking about health care rationing? Does rationing health care unfairly discriminate against the elderly and people with disabilities? Should patients be held responsible for their health? Why does the debate on responsibility for health lead to issues about socioeconomic status and social inequality? Throughout the book, examples from the US, UK and other countries are used to illustrate the ethical issues at stake. Additional features such as chapter summaries, annotated further reading and discussion questions make this an ideal starting point for students new to the subject, not only in philosophy but also in closely related fields such as politics, health economics, public health, medicine, nursing and social work.