title: Competition and the patient-centered ethic.
abstract: This essay critically evaluates the claim that competition in medicine destroys the moral integrity of the traditional patient-physician relationship. The author argues that the traditional patient-centered ethic is indefensible on moral grounds, and that it should be jettisoned in favor of a fiduciary ethic. A fiduciary ethic is found to provide the best defensible account of the patient-physician relationship because it takes seriously the roles economic efficiency, competition, and respect for individual self-determination play in fashioning moral health care delivery.
mesh_terms: D000574:American Medical Association; D001318:Authoritarianism; D030881:Disclosure; D004465:Economic Competition; D004467:Economics; D004992:Ethics, Medical; D006296:Health Services / Q000191:economics*; D006801:Humans; D009014:Morals; D026706:Paternalism; D018579:Patient Selection; D010686:Philosophy, Medical; D010817:Physician-Patient Relations; D012926:Social Control, Formal; D014481:United States