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Medicine and the Marketplace: the Moral Dimensions of Managed Care
  1. John F Peppin
  1. Center for Bioethics, Pain Management and Medicine, Des Moines, Iowa, USA.

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    Kenman L Wong, Notre Dame, Indiana, University of Notre Dame Press, 1998, 232 pages, $32.00

    Health care in our society has reached a critical point in its evolution. Numerous articles have decried current approaches to health care reimbursement by focusing on their negative impact on patient relationships. However, few have reflected on the encroaching import of business ethics on these relationships. Kenman Wong's book Medicine and the Marketplace is a critical first beginning of this reflection. Wong engages in a comprehensive ethical assessment of managed care and the impact of business ethics on obligations to patients. As Wong rightly observes, the ethical discussions concerning health care and its economics, focus on obligations of physicians not those of institutions or other health care professionals. However, health care institutions are increasingly interposed between the physician and patient and their decisions are based on …

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