title: "Damaged humanity": the call for a patient-centered medical ethic in the managed care era.
abstract: Edmund Pellegrino claims that medical ethics must be derived from a perception of the patient's "damaged humanity," rather than from the self-imposed duties of professionals. This essay explores the meaning and examines the challenges to this patient-centered ethic. Social scientific and bioethical interpretations of medicine constitute one kind of challenge. A more pervasive challenge is the ascendancy of managed care, and especially investor-owned, for-profit managed care. A list of questions addressed to patients, physicians and organizations is offered as one means of assessing this threat and moving toward morally trustworthy relationships.
authors.affiliation: University of North Carolina at Chapel Hill, USA.
authors.forename: L R
authors.initials: LR
authors.lastname: Churchill
mesh_terms: D032781:Codes of Ethics; D032882:Comprehension; D030881:Disclosure; D028663:Ethical Theory; D026822:Ethicists; D004992:Ethics, Medical; D015276:Health Care Rationing / Q000592:standards; D007722:Health Knowledge, Attitudes, Practice; D049673:History, 20th Century; D006808:Humanism; D008329:Managed Care Programs / Q000266:history; D026706:Paternalism; D018802:Patient-Centered Care; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians'; D040841:Resource Allocation; D014481:United States; D028761:Withholding Treatment