title: Help from Hume reconciling professionalism and managed care.
abstract: Health care systems are widely criticized for limiting doctors' roles as patient-advocates. Yet unrestricted advocacy can be unfairly partial, costly, and prejudicial. This essay considers three solutions to the problem of how to reconcile the demands of a just health care system for all patients, with the value of advocacy for some. Two views are considered and rejected, one supporting unlimited advocacy and another defending strict impartiality. A third view suggested by Hume's moral theory seeks to square the moral demands of professional advocacy and just health care systems. A moral basis for limited advocacy exists when it can be justified from a general or moral vantage. Consequently, ethical aspects of professionalism are not necessarily on a collision course with health care systems incorporating managed care. This solution is compatible with goals regarding the importance of humanistic education and professionalism to build patients' trust.
authors.affiliation: Department of Medical Humanities, East Carolina University School of Medicine, Greenville, NC 27858, USA.
authors.forename: L M
authors.initials: LM
authors.lastname: Kopelman
mesh_terms: D026686:Beneficence; D004992:Ethics, Medical; D004995:Ethics, Professional; D033062:Friends; D049671:History, 18th Century; D006801:Humans; D008329:Managed Care Programs; D028681:Moral Obligations; D009014:Morals; D018579:Patient Selection; D010686:Philosophy, Medical / Q000266:history; D010817:Physician-Patient Relations; D040841:Resource Allocation; D035502:Trust