Ethical Dilemmas of Reform

The Health Care Blog:

San Francisco surgeon Hootan Roozrokh faces one felony charge of dependent adult abuse, for which the maximum punishment is four years in prison. Roozrokh, 34, has pleaded not guilty and his attorney, M. Gerald Schwartzbach said his client looks forward to clearing his name at trial.

The Roozrokh case has attracted much national attention and raises worrisome questions about whether the transplant community is pressing too hard to increase the nation’s organ supply, thereby creating situations ripe for blurring ethical boundaries, such as this one.

Medicine is full of ethical dilemmas that providers must confront on a daily basis. This case shows what can result as ethical boundaries gradually gray.

While we debate the likelihood of health care reform and the form of which it may take, the most important conversations may take place post-reform decision. We must consider the ethical dilemmas we will be presented with as a result of any cost cutting measures, insurance coverage plans, methods of financing, etc.

Some of the most expensive care in this country occurs at the end of a person’s life. That is to be expected as providers try to save lives. This isn’t the case all the time, however. A 2006 USA Today article:

While researchers are able to show differences in costs, the real question remains how much of those additional hospitalizations, tests and doctor visits resulted in better care or better quality of life? Finding answers to that question is difficult and controversial, but health policy experts say doing so will become increasingly important as the U.S. seeks ways to slow the rapid rise in health care spending.

Any health care reform debates ought to include conversations of the ethical implications. Lowering costs may mean a reduction in actual care provided.  Is that a good thing?  A bad thing?  The warranted answer: It depends.

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