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During the last two decades, applied ethics has not only developed into one of the most important philosophical disciplines but has also differentiated into so many subdisciplines that it is becoming increasingly difficult to survey it. A much-needed overview is provided by the eighteen contributions to this volume, in which internationally renowned experts deal with central questions of environmental ethics, bioethics and medical ethics, professional and business ethics, social, political, and legal ethics as well as with the aims and foundations of applied ethics in general. Thanks to a philosophical introduction and selected bibliographical references added to each chapter, the book is very well suited as a basis for courses in applied ethics. It is directed not only to philosophers and to ethicists from other disciplines but to scientists in general and to all people who are interested in the rational discussion of moral principles and their application to concrete problems in the sciences and in everyday life.
What are the acceptable limits of scientific investigation and genetic engineering, the rights and wrongs of animal rights, euthanasia and civil disobedience? This book confronts these dilemmas, tracing arguments of moral thinkers, including Socrates, Plato, Aristotle, and brings us up to date with postmodern critics.
Marc A. Rodwin draws on his own experience as a health lawyer–and his research in health ethics, law, and policy–to reveal how financial conflicts of interest can and do negatively affect the quality of patient care. He shows that the problem has become worse over the last century and provides many actual examples of how doctors’ decisions are influenced by financial considerations. We learn how two California physicians, for example, resumed referrals to Pasadena General Hospital only after the hospital started paying $70 per patient (their referrals grew from 14 in one month to 82 in the next). As Rodwin writes, incentives such as this can inhibit a doctor from taking action when a hospital fails to provide proper service, and may also lead to the unnecessary hospitalization of patients. We also learn of a Wyeth-Ayerst Labs promotion in which physicians who started patients on INDERAL (a drug for high blood pressure, angina, and migraines) received 1000 mileage points on American Airlines for each patient (studies show that promotions such as this have a direct effect on a doctor’s choice of drug). Rodwin reveals why the medical community has failed to regulate conflicts of interest: peer review has little authority, state licensing boards are usually ignorant of abuses, and the AMA code of ethics has historically been recommended rather than required. He examines what can be learned from the way society has coped with the conflicts of interest of other professionals –lawyers, government officials, and businessmen–all of which are held to higher standards of accountability than doctors. And he recommends that efforts be made to prohibit and regulate certain kinds of activity (such as kickbacks and self-referrals), to monitor and regulate conduct, and to provide penalties for improper conduct. Our failure to face physicians’ conflicts of interest has distorted the way medicine is practiced, compromised the loyalty of doctors to patients, and harmed society, the integrity of the medical profession, and patients. For those concerned with the quality of health care or medical ethics, Medicine, Money and Morals is a provocative look into the current health care crisis and a powerful prescription for change.
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