The Doctor’s Failure To Cut Costs
On wards and in intensive care units, when doctors, nurses, patients and families find themselves at odds with one another, they inevitably turn to the experts of last resort: the bioethicists.
Regularly called upon to weigh in on issues including life support, human research, patient rights and organ transplantation, bioethicists are known for bringing clarity to situations so overwrought with opinions, values and special interests that consensus appears impossible.
Now, as the search for consensus in health care reform grinds toward the end of its first year, a national leader in bioethics has cast his critical eye on the debate. At issue, however, are not the usual moral suspects: pharmaceutical manufacturers, medical device makers and hospitals. This time it is physicians who have lapsed in their ethical responsibilities.
In an editorial in The New England Journal of Medicine, Dr. Howard Brody, professor of family medicine and director of the Institute for the Medical Humanities at the University of Texas Medical Branch in Galveston, writes that the medical profession, unlike other groups, has made little effort to curtail future medical costs. Physicians, Dr. Brody maintains, are not “innocent bystanders” to spiraling health care costs but have been complicit in their failure to take an active role in curtailing them.