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Managed Care as Regulation: Functional Ethics for a Regulated Environment

Published online by Cambridge University Press:  01 January 2021

Sandra H. Johnson
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Extract

Analysis in bioethics has relied primarily on the identification and application of general principles and on the examination of particular paradigmatic cases. Principalism and casuistry depend on an assumption of generalizability; that is, that learning and insights gained from an understanding of the principles or the case may be effectively applied to other similar situations. For the most part, the particular characteristics of the institutional setting have not played a central role in these approaches. It would appear, then, that what has been learned in the context of one health care setting is transferable, with some few adjustments, to another.

The institutional context does make both a practical and a substantive difference, however, and shifting ethical analyses from one context to another has sometimes proven difficult. This has been so, for example, in the context of nursing home care.

Type
Article
Information
Journal of Law, Medicine & Ethics , Volume 23 , Issue 3 , Fall 1995 , pp. 266 - 272
Copyright
Copyright © American Society of Law, Medicine and Ethics 1995

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References

See generally Pellegrino, Edmund D., “The Metamorphosis of Medical Ethics: A 30-Year Retrospective”, JAMA, 269 (1993): 1158–62; Rothenberg, Karen, “New Perspectives for Teaching and Scholarship: The Role of Gender in Law and Health Care,” Maryland Law Review, 54 (1995): 473–87; and Wolf, Susan M., “Shifting Paradigms in Bioethics and Health Law: The Rise of a New Pragmatism,” American Journal of Law & Medicine, XX (1994): 395–415.CrossRefGoogle Scholar
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See, for example, Letter from Vivienne Wisdom, Executive Director of the New Hampshire Health Care Association to Sununu, John, Mar. 11, 1991 (describing that the members of the New Hampshire Health Care Association (a nursing home trade association) experienced “profound improvement in the quality of life,” increased staff morale, and more frequent visitors to residents on reduction of restraints).Google Scholar
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