Ethics of managed medicine

Abstract

The “principlism” philosophical school is based on four fundamental principles: justice, beneficence, nonmaleficence and autonomy. The latter acquired great development starting on the 70s-80s. Autonomy taken to an extreme could be an obstacle for the physician-patient relationship; so it is “economy”. As the concept of sanitary care as a social justice citizen right developed, the problem of financing the care provided arose. Economists blame physicians for not appreciating health management and resource prioritizing, given the limited nature of the latter. The validity of administrative and financial health management could be distorted when it is considered a goal and not a means. Patient care is the goal of medicine and economy is a means to attain this goal. Profit could never be the motor of health economy: That is the reason why the use of terms such as client instead of patient, and company instead of clinic or hospital are debatable.