Insurers are demonstrating an expanding repertoire of practices designed to reduce the provision of medical care. Medical decision-making is no longer a privileged domain for those involved in direct patient care. The market has been brought to bear in health care. Under the guise of cost-efficiency and accountability, dangerous constraints are being placed upon doctors and their patients. The complexity of clinical reasoning makes it virtually impossible to link medical ethics with business ethics.
Conflicting obligations are certain if clinicians deliberate resource allocation.
Physicians have a moral duty to make clinical decisions based upon the biological, the empirical. Ethical dilemmas in the profession of medicine have long been inseparable from its practice. Notwithstanding, recent problems raise extraordinary concerns. A revised code of ethics now permits third party insurers to refuse treatment. In behalf of their patients, physicians have a moral obligation to lodge explicit protest.