RT Journal Article
SR Electronic
T1 Ethics and high-value care
JF Journal of Medical Ethics
JO J Med Ethics
FD BMJ Publishing Group Ltd and Institute of Medical Ethics
SP 307
OP 309
DO 10.1136/medethics-2016-103880
VO 43
IS 5
A1 DeCamp, Matthew
A1 Tilburt, Jon C
YR 2017
UL http://jme.bmj.com/content/43/5/307.abstract
AB High-value care (HVC) is en vogue, but the ethics of physicians’ roles in the growing number of HVC recommendations demands further attention. In this brief report, we argue that, from the standpoint of individual physicians’ primary commitments and duties to individual patients, not all HVC is ethically equal. Our analysis suggests that the ethical case for HVC may be both stronger and weaker than is ordinarily supposed. In some cases, HVC is not merely a ‘good thing to do’ but is actually ethically obligatory. In others, it is merely permissible—or even ethically suspect. More importantly, we suggest further that understanding HVC as ethically ‘obligatory, permissible, or suspect’ has implications for the design and implementation of strategies that promote HVC. For example, it questions the use of adherence to certain HVC recommendations as a physician performance metric, which may already be occurring in some contexts. Properly construed, ethics does not threaten HVC but can instead help shape HVC in ways that preserve the fundamental values of the medical profession.