title: Bluffing, puffing and spinning in managed-care organizations.
abstract: I argue that because bluffing, puffing, and spinning are features of corporate life, they are likely to characterize the doctor-patient relationship in managed care medicine. I show that managed-care organizations (MCOs) and the physicians who contract with them make liberal use of puffing and spinning. In this way, they create a context in which it is likely that patients will also use deceptive mechanisms. Unfortunately, patients risk their health when they deceive their doctors. Using the warranty theory of truth I argue that although bluffing may be ethical in business because all participants agree to it and business has not warranted truth-telling, it is not ethical in a medical context because physicians and MCOs have warranted truth-telling and the quality of medical care depends on it.
authors.affiliation: Department of Philosophy and Religion, Northeastern University, Boston, Massachusetts 02115, USA.
authors.forename: P
authors.initials: P
authors.lastname: Illingworth
mesh_terms: D008192:Deception; D030881:Disclosure; D004989:Ethics; D040861:Ethics, Business; D004991:Ethics, Institutional; D006801:Humans; D008329:Managed Care Programs / Q000458:organization & administration* / Q000592:standards; D010817:Physician-Patient Relations; D011787:Quality of Health Care; D040841:Resource Allocation; D035502:Trust; D014342:Truth Disclosure; D028761:Withholding Treatment