title: Cost cutting: substandard care.
abstract: Mr. Edwards is diagnosed with a heart arrhythmia and is treated with a successful regimen of medication. He joins an HMO and begins care under a new doctor who ponders whether he should switch Mr. Edwards' medical regimen. Changing the treatment would save the HMO money that could be allocated among other patients, but would expose Mr. Edwards to a small risk of fatal heart attack. I argue that the doctor should not change the medication without the patient's considerations for the following reasons: doctors ought to work solely for the welfare of the patient, the patient has no obligation to cut HMO costs; and allowing doctors' treatment decisions to be influenced by third a party would have negative social repercussions. Furthermore, an informative doctor-patient relationship would be preferred over other "relationship models" for determining Mr. Edwards' course of medication.
authors.affiliation: Carnegie Mellon University, USA.
authors.forename: Katherin
authors.initials: K
authors.lastname: Peperzak
mesh_terms: D001145:Arrhythmias, Cardiac / Q000188:drug therapy*; D015276:Health Care Rationing / Q000191:economics*; D006279:Health Maintenance Organizations / Q000191:economics*; D006801:Humans; D010817:Physician-Patient Relations; D028761:Withholding Treatment