title: Contemporary view of the effect of managed care on the ethics in perinatal medicine.
abstract: Managed care has significantly altered the patient-physician relationship, and these changes have created new ethical challenges within that relationship. The physician's obligation of beneficence has been challenged by his contract with managed care. Physicians have faced increasing apparent and real conflicts of interest. The patient's right of choice has been challenged by her contract with managed care. Within perinatal medicine, those challenges have affected mode of delivery, use of technology, length of stay, and pharmaceutical choices. Additional challenges and opportunities to enhance quality of care lie ahead in the evolution of the health care system.
authors.affiliation: Reading Hospital and Medical Center, Department of Obstetrics and Gynecology, PO Box 16052, Reading, PA 19612-6052, USA. Schwartzp@readinghospital.org
authors.forename: Peter A
authors.initials: PA
authors.lastname: Schwartz
mesh_terms: D003363:Cost Control; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008329:Managed Care Programs / Q000191:economics / Q000941:ethics*; D010500:Perinatology / Q000191:economics / Q000941:ethics*; D010817:Physician-Patient Relations; D011247:Pregnancy; D014481:United States