title: Ethics in managed care.
abstract: The current era of managed costs and care create ethical dilemmas based on economic constraints and incorporation of principles of distributive justice. Traditional ethical concerns related to confidentiality, conflicts of interest, double agentry, and honesty are complicated by interference in the doctor-patient relationship caused by intrusive utilization management. National health reform must take these issues seriously to ensure that the cure promised by such reform efforts is not worse than the disease. The challenge for psychiatrists is to adapt to these constraints without losing sight of traditional ethical medical positions. If the ethics become diseased, then no cure may exist at all.
authors.affiliation: University of Colorado Health Sciences Center, 8095 E. Prentice Avenue, Greenwood Village, CO 80111, USA. Jeremy.Lazarus@UCHSC.edu
authors.forename: Jeremy A
authors.initials: JA
authors.lastname: Lazarus
authors.forename: Steven S
authors.initials: SS
authors.lastname: Sharfstein
mesh_terms: D000328:Adult; D003219:Confidentiality / Q000941:ethics; D016265:Conflict of Interest; D004991:Ethics, Institutional; D004992:Ethics, Medical; D006801:Humans; D008297:Male; D008329:Managed Care Programs / Q000191:economics / Q000941:ethics*; D001523:Mental Disorders / Q000191:economics / Q000628:therapy; D008605:Mental Health Services / Q000191:economics / Q000941:ethics*; D010817:Physician-Patient Relations / Q000941:ethics; D011570:Psychiatry / Q000941:ethics; D012935:Social Justice; D014481:United States; D014600:Utilization Review / Q000941:ethics