Of course doctors should only recommend indicated treatments and not make decisions on the basis of HMO financial incentives that add to the bottom line. But the truth is gray, not black and white. Not all financial incentives are bad, and not all patient choices are good. The ethical pendulum has swung all the way to patient autonomy as the first, most important, and some would argue the only real principle in medical ethics. That makes no sense, much less a principled argument.
Most people think of autonomy as choice alone.
But it's not. Genuine autonomy is the ability to make an informed choice. It's the freedom and capacity not to choose, or to delegate choice, or to choose with someone. In medicine, it usually turns on a particular patient in a particular set of circumstances at a particular moment in time. How it's defined Most of us think of ethics as what we should do.