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The obligation of physicians to medical outliers: a Kantian and Hegelian synthesis

BACKGROUND: Patients who present to medical practices without health insurance or with serious co-morbidities can become fiscal disasters to those who care for them. Their consumption of scarce resources has caused consternation among providers and institutions, especially as it concerns the amount...

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Autores principales: Papadimos, Thomas J, Marco, Alan P
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2004
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC425590/
https://www.ncbi.nlm.nih.gov/pubmed/15176981
http://dx.doi.org/10.1186/1472-6939-5-3
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author Papadimos, Thomas J
Marco, Alan P
author_facet Papadimos, Thomas J
Marco, Alan P
author_sort Papadimos, Thomas J
collection PubMed
description BACKGROUND: Patients who present to medical practices without health insurance or with serious co-morbidities can become fiscal disasters to those who care for them. Their consumption of scarce resources has caused consternation among providers and institutions, especially as it concerns the amount and type of care they should receive. In fact, some providers may try to avoid caring for them altogether, or at least try to limit their institutional or practice exposure to them. DISCUSSION: We present a philosophical discourse, with emphasis on the writings of Immanuel Kant and G.F.W. Hegel, as to why physicians have the moral imperative to give such "outliers" considerate and thoughtful care. Outliers are defined and the ideals of morality, responsibility, good will, duty, and principle are applied to the care of patients whose financial means are meager and to those whose care is physiologically futile. Actions of moral worth, unconditional good will, and doing what is right are examined. SUMMARY: Outliers are a legitimate economic concern to individual practitioners and institutions, however this should not lead to an evasion of care. These patients should be identified early in their course of care, but such identification should be preceded by a well-planned recognition of this burden and appropriate staffing and funding should be secured. A thoughtful team approach by medical practices and their institutions, involving both clinicians and non-clinicians, should be pursued.
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spelling pubmed-4255902004-06-18 The obligation of physicians to medical outliers: a Kantian and Hegelian synthesis Papadimos, Thomas J Marco, Alan P BMC Med Ethics Debate BACKGROUND: Patients who present to medical practices without health insurance or with serious co-morbidities can become fiscal disasters to those who care for them. Their consumption of scarce resources has caused consternation among providers and institutions, especially as it concerns the amount and type of care they should receive. In fact, some providers may try to avoid caring for them altogether, or at least try to limit their institutional or practice exposure to them. DISCUSSION: We present a philosophical discourse, with emphasis on the writings of Immanuel Kant and G.F.W. Hegel, as to why physicians have the moral imperative to give such "outliers" considerate and thoughtful care. Outliers are defined and the ideals of morality, responsibility, good will, duty, and principle are applied to the care of patients whose financial means are meager and to those whose care is physiologically futile. Actions of moral worth, unconditional good will, and doing what is right are examined. SUMMARY: Outliers are a legitimate economic concern to individual practitioners and institutions, however this should not lead to an evasion of care. These patients should be identified early in their course of care, but such identification should be preceded by a well-planned recognition of this burden and appropriate staffing and funding should be secured. A thoughtful team approach by medical practices and their institutions, involving both clinicians and non-clinicians, should be pursued. BioMed Central 2004-06-03 /pmc/articles/PMC425590/ /pubmed/15176981 http://dx.doi.org/10.1186/1472-6939-5-3 Text en Copyright © 2004 Papadimos and Marco; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.
spellingShingle Debate
Papadimos, Thomas J
Marco, Alan P
The obligation of physicians to medical outliers: a Kantian and Hegelian synthesis
title The obligation of physicians to medical outliers: a Kantian and Hegelian synthesis
title_full The obligation of physicians to medical outliers: a Kantian and Hegelian synthesis
title_fullStr The obligation of physicians to medical outliers: a Kantian and Hegelian synthesis
title_full_unstemmed The obligation of physicians to medical outliers: a Kantian and Hegelian synthesis
title_short The obligation of physicians to medical outliers: a Kantian and Hegelian synthesis
title_sort obligation of physicians to medical outliers: a kantian and hegelian synthesis
topic Debate
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC425590/
https://www.ncbi.nlm.nih.gov/pubmed/15176981
http://dx.doi.org/10.1186/1472-6939-5-3
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