Ethics consultations masking economic dilemmas in patient care.
The ethical and economic aspects of treatment decisions are often intimately entwined. We demonstrate how clinical economic questions were raised in clinical ethics consultations involving three patients: a 49-year-old retarded man who required short-term tube feeding; a 74-year-old man with metastatic prostatic cancer whose relatives disagreed about whether or not he should have surgical treatment; and a 55-year-old man whose health maintenance organization declined to pay for liver transplantation. Ethics consultants can help to clarify financial constraints and to resolve financial conflicts of interest. All physicians must develop the ability to unmask economic issues in medical care.
Schiedermayer
D L
DL
Department of Medicine, Medical College of Wisconsin, Milwaukee 53226.
La Puma
J
J
Miles
S H
SH
D000368:Aged; D004750:Enteral Nutrition / Q000191:economics; D026822:Ethicists; D033061:Ethics Consultation; D004992:Ethics, Medical; D005190:Family; D005260:Female; D006279:Health Maintenance Organizations / Q000191:economics; D006801:Humans; D008113:Liver Neoplasms / Q000191:economics / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D018579:Patient Selection; D010818:Practice Patterns, Physicians' / Q000191:economics*; D011471:Prostatic Neoplasms / Q000191:economics / Q000601:surgery; D012017:Referral and Consultation; D040841:Resource Allocation; D028761:Withholding Treatment