Anne Drapkin Lyerly, MD, MA and Ruth R. Faden, PhD, MPH
Participation in a research study—in which there are rigorous standards and close monitoring—may be a safer context for the use of medications in pregnancy than the clinical setting, where the evidence base is lacking.
Shivan J. Mehta, MD, MBA and David A. Asch, MD, MBA
Outcome-based payment more closely aligns payments with what patients want, which is better health rather than more health care. But these approaches remain challenging to implement.
Measuring outcomes alone is not the answer. There should be a way to reward the doctor for educating a patient about lifestyle modifications and then documenting that the care provided followed patient preferences.
The picture that emerges from study of physician economic behavior is mixed, but from the intensity of responses by some professional societies to Medicare's coding modifier proposal, it appears that economic incentives matter a lot to many of their members.
Some disability advocates take issue with the “normalization” goals of the medical model of rehabilitation, but expressions of that position can be dismissive of rehabilitationists’ efforts to remediate oppressive functional deficits.
AMA J Ethics. 2015;17(6):562-567. doi:
10.1001/journalofethics.2015.17.6.msoc1-1506.
The FDA’s expanded access pathway allows patients with no other therapeutic options to request access to investigational agents, but manufacturers do not often grant it.
AMA J Ethics. 2015;17(12):1142-1146. doi:
10.1001/journalofethics.2015.17.12.stas1-1512.
The casebook developed by the Bander Center for Medical Business Ethics provides a comprehensive instrument for teaching medical business ethics decision making by exploring the effects of relevant variables on medical practice and research and reflecting on the values and motives that influence the behavior of health care professionals.
AMA J Ethics. 2015;17(8):744-749. doi:
10.1001/journalofethics.2015.17.8.medu1-1508.