Too Conscientious The Evolution Of Ethical Challenges To Professionalism In The American Medical Marketplace

This book addresses the fundamental conflict of interest that physicians face in their daily work lives between the ethics of proper medical care versus the demands of standard business practices. However, unlike other books of this sort, this one places direct responsibility for this ethical dilemma upon the shoulders of physicians themselves. Taking ethical, legal, and business perspectives into account, the book traces the historically evolving response of American physicians to ever-increasing business interests within the profession. These financial concerns now have become intrinsic not only to the practice of medicine but seemingly also to the character of a growing segment of its practitioners. The book offers a plea for a change to a more socialized healthcare system as used in other advanced nations.

This book addresses the fundamental conflict of interest that physicians face in their daily work lives between the ethics of proper medical care versus the demands of standard business practices. However, unlike other books of this sort, this one places direct responsibility for this ethical dilemma upon the shoulders of physicians themselves. Taking ethical, legal, and business perspectives into account, the book traces the historically evolving response of American physicians to ever-increasing business interests within the profession. These financial concerns now have become intrinsic not only to the practice of medicine but seemingly also to the character of a growing segment of its practitioners. The book offers a plea for a change to a more socialized healthcare system as used in other advanced nations.

This book stages a provocative dialogue between social work, health and social care and contemporary philosophy in order to inform theory and practice in a complex and challenging world. Today, the social world is marked by deep-rooted complexities, tensions and challenges. Health workers and social workers are constantly reminded to employ critical thinking to navigate this world through their practice. But given how many of these challenges pose significant problems for the theories that these subjects have traditionally drawn upon, should we now be critical of critical thinking – its assumptions, its basis and its aspirations – itself? Arguing that health and social work theory must reconsider its deep-rooted assumptions about criticality in order to navigate complex neoliberalism, post-truth and the relationship between language and late capitalism, it examines how the fusion of theory and practice can re-imagine critical thinking for health, social care and social work. It will be of interest to all scholars, students and professionals of social work and health and social care.

​The goal of this open access book is to develop an approach to clinical health care ethics that is more accessible to, and usable by, health professionals than the now-dominant approaches that focus, for example, on the application of ethical principles. The book elaborates the view that health professionals have the emotional and intellectual resources to discuss and address ethical issues in clinical health care without needing to rely on the expertise of bioethicists. The early chapters review the history of bioethics and explain how academics from outside health care came to dominate the field of health care ethics, both in professional schools and in clinical health care. The middle chapters elaborate a series of concepts, drawn from philosophy and the social sciences, that set the stage for developing a framework that builds upon the individual moral experience of health professionals, that explains the discontinuities between the demands of bioethics and the experience and perceptions of health professionals, and that enables the articulation of a full theory of clinical ethics with clinicians themselves as the foundation. Against that background, the first of three chapters on professional education presents a general framework for teaching clinical ethics; the second discusses how to integrate ethics into formal health care curricula; and the third addresses the opportunities for teaching available in clinical settings. The final chapter, "Empowering Clinicians", brings together the various dimensions of the argument and anticipates potential questions about the framework developed in earlier chapters.

Historically associated with military service, conscientious objection has become a significant phenomenon in health care. Mark Wicclair offers a comprehensive ethical analysis of conscientious objection in three representative health care professions: medicine, nursing and pharmacy. He critically examines two extreme positions: the 'incompatibility thesis', that it is contrary to the professional obligations of practitioners to refuse provision of any service within the scope of their professional competence; and 'conscience absolutism', that they should be exempted from performing any action contrary to their conscience. He argues for a compromise approach that accommodates conscience-based refusals within the limits of specified ethical constraints. He also explores conscientious objection by students in each of the three professions, discusses conscience protection legislation and conscience-based refusals by pharmacies and hospitals, and analyzes several cases. His book is a valuable resource for scholars, professionals, trainees, students, and anyone interested in this increasingly important aspect of health care.

In this original and compelling book, Jeffrey P. Bishop, a philosopher, ethicist, and physician, argues that something has gone sadly amiss in the care of the dying by contemporary medicine and in our social and political views of death, as shaped by our scientific successes and ongoing debates about euthanasia and the “right to die”—or to live. The Anticipatory Corpse: Medicine, Power, and the Care of the Dying, informed by Foucault’s genealogy of medicine and power as well as by a thorough grasp of current medical practices and medical ethics, argues that a view of people as machines in motion—people as, in effect, temporarily animated corpses with interchangeable parts—has become epistemologically normative for medicine. The dead body is subtly anticipated in our practices of exercising control over the suffering person, whether through technological mastery in the intensive care unit or through the impersonal, quasi-scientific assessments of psychological and spiritual “medicine.” The result is a kind of nihilistic attitude toward the dying, and troubling contradictions and absurdities in our practices. Wide-ranging in its examples, from organ donation rules in the United States, to ICU medicine, to “spiritual surveys,” to presidential bioethics commissions attempting to define death, and to high-profile cases such as Terri Schiavo’s, The Anticipatory Corpse explores the historical, political, and philosophical underpinnings of our care of the dying and, finally, the possibilities of change. This book is a ground-breaking work in bioethics. It will provoke thought and argument for all those engaged in medicine, philosophy, theology, and health policy.

Discussions of professional ethics tend to emphasize what not to do. Why, Michael Pritchard asks, should they not also consider the ethical heights to which professionals should aspire? Pritchard, who has taught professional ethics for more than twenty-five years, here explores the interplay of virtues, ideals, and moral rules in everyday life and the professions. In elegant prose, he emphasizes the positive dimension of professional ethics-actions that thoughtful, conscientious people ought to perceive and pursue in their careers. As Pritchard observes, problems of professional ethics originate in an increasingly specialized society where few people are able to evaluate, let alone discredit, the actions of any given expert; all too often, we trust experts because it's all we can do. Pritchard addresses this concern by focusing on different conceptions of the responsibilities of individual professionals, illustrating the best of what professional ethics might offer through true stories of people from various professions—engineering, business, architecture, the health sciences—who have felt ethically impelled to go beyond the call of duty. Integrating moral theory with a wide range of practical concerns-good works, cooperation, trustworthiness—Pritchard shows how professionals might make conscious decisions for good, such as performing socially meaningful work for lower compensation or persevering to see a project through to a proper outcome. Extending the work of developmental psychologists to the realm of professional ethics, he shows how to foster character in responsible professionals through postsecondary education and professional guilds-and urges that even children should be encouraged to envision the greater good. Professional Integrity offers valuable insights not only for philosophers interested in professional responsibility but also for general readers in a variety of settings, demonstrating that practical ethics and professional responsibility are rich and complex notions that require skills and character traits that ideally need to be cultivated at an early age. In an era of insider trading, kickbacks, and cooked books, it speaks to a long-felt need with a refreshingly positive approach.

An introduction to the new health care for profit. Legal differences between investor-owned and nonprofit health care institutions. Wall Street and the for-profit hospital management companies. When investor-owned corporations buy hospitals: some issues and concerns. Physician involvement in hospital decision making. Economic incentives and clinical decisions. Ethical dilemmas of for-profit enterprise in health care. Secondary income from recommended treatment: should fiduciary principles constrain physician behavior?