strangers in the night law and medicine in the managed care era

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Strangers In The Night

Author : Peter D. Jacobson
ISBN : 019976073X
Genre : Law
File Size : 48. 93 MB
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More than ever before, the legal system plays a vital role in virtually every aspect of the current health care system. From the congressional debate over patients' rights legislation to judicial rulings on the denial of health care services, the legal system is integrally involved in the organization, financing, and delivery of health care. This book explains how the legal system helps shape health care delivery and policy, explores new ways of looking at the relationship between law and medicine, and reflects on why it all matters. The story focuses on the judicial response to the advent of managed care, especially challenges to cost containment initiatives, and shows how the legal system has facilitated managed care's dominance over the health care system. An equally important part of the story is the evolution of the relationship between physicians and attorneys and how their mutual antagonism affects patient care. In the end, the stories come together around a strategy for reconciling the difficult health policy choices the country faces and for restoring the physician-patient relationship to the center of health care delivery.

False Hope

Author : Richard A. Rettig
ISBN : 9780190293215
Genre : Medical
File Size : 63. 79 MB
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In the late 1980s, a promising new treatment for breast cancer emerged: high-dose chemotherapy with autologous bone marrow transplantation or HDC/ABMT. By the 1990s, it had burst upon the oncology scene and disseminated rapidly before having been carefully evaluated. By the time published studies showed that the procedure was ineffective, more than 30,000 women had received the treatment, shortening their lives and adding to their suffering. This book tells of the rise and demise of HDC/ABMT for metastatic and early stage breast cancer, and fully explores the story's implications, which go well beyond the immediate procedure, and beyond breast cancer, to how we in the United States evaluate other medical procedures, especially life-saving ones. It details how the factors that drove clinical use--patient demand, physician enthusiasm, media reporting, litigation, economic exploitation, and legislative and administrative mandates--converged to propel the procedure forward despite a lack of proven clinical effectiveness. It also analyzes the limited effect of technology assessments before randomized clinical trials evaluated decisively the procedure and the ramifications of this system on healthcare today. Sections of the book consider the initial conditions surrounding the emergence of the new breast cancer treatment, the drivers of clinical use, and the struggle for evidence-based medicine. A concluding section considers the significance of the story for our healthcare system.

Conflicts Of Interest And The Future Of Medicine

Author : Marc A. Rodwin
ISBN : 9780199793044
Genre : Political Science
File Size : 79. 59 MB
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As most Americans know, conflicts of interest riddle the US health care system. They result from physicians practicing medicine as entrepreneurs, from physicians' ties to pharma, and from investor-owned firms and insurers' influence over physicians' medial choices. These conflicts raise questions about physicians' loyalty to their patients and their professional and economic independence. The consequences of such conflicts of interest are often devastating for the patients--and society--stuck in the middle. In Conflicts of Interest and the Future of Medicine, Marc Rodwin examines the development of these conflicts in the US, France, and Japan. He shows that national differences in the organization of medical practice and the interplay of organized medicine, the market, and the state give rise to variations in the type and prevalence of such conflicts. He then analyzes the strategies that each nation employs to cope with them. Unfortunately, many proposals to address physicians' conflicts of interest do not offer solutions that stick. But drawing on the experiences of these three nations, Rodwin demonstrates that we can mitigate these problems with carefully planned reform and regulation. He examines a range of measures that can be taken in the private and public sector to preserve medical professionalism--and concludes that there just might be more than one prescription to this seemingly incurable malady.

American Jurisprudence Trials

Author :
ISBN : STANFORD:36105061317678
Genre : Trial practice
File Size : 78. 34 MB
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An encyclopedic guide to the modern practices, techniques, and tactics used in preparing and trying cases, with model programs for the handling of all types of litigation.

Moral Dilemmas In Community Health Care

Author : Becky Cox White
ISBN : 0321133552
Genre : Medical
File Size : 23. 91 MB
Format : PDF
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Examining the “:everyday” issues that arise in community practice, Moral Dilemmas in Community Health Care pulls together real questions, concerns, and dilemmas faced in by health care professionals working in community settings and smaller facilities and provide a simple framework for evaluating those dilemmas. Many different types of health care professionals comment on the cases, not just ethicists and physicians. Cases focus on a wide range of community-based dilemmas and are set in small community hospitals, ancillary health care institutions, and doctors' offices. Readers see cases from settings that most health care professionals will work in and learn about issues professionals in ordinary health care professionals AND ordinary patients face.

The U S Supreme Court And Medical Ethics

Author : Bryan Hilliard
ISBN : UOM:39015058872733
Genre : Law
File Size : 86. 91 MB
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Few deny the impact on physicians, patients, and patients' families of US Supreme Court decisions. Actions the Court takes, or refuses to take, carry implications for how patients receive care, the type of care they receive, how medical care will be paid for, the extent to which patients can trust their doctors, and even how patients die. Below the surface of constitutional interpretation and judicial temperament lie ethical commitments and value considerations. Justices do not decide cases, especially biomedical ethics cases, in a vacuum. Too much is at stake for those involved in health care--receiving services, providing care, or studying its moral constraints--to ignore the explicit and implicit ethical considerations of the Justices. The book examines the rulings and the individual opinions of justices on important biomedical issues including: Contraception, Confidentiality, Abortion, Reproductive Freedom, Assisted Suicide, Mental Illness, Religious Objection to Treatment, Medical Regulation, and Health Care Rights.

Health Law

Author :
ISBN : STANFORD:36105064229417
Genre : Law
File Size : 79. 17 MB
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For more than two decades, Health Law: Cases, Materials and Problems has defined the field of health law, providing a balanced overview of law as it affects patients, professionals, institutions, and entities that deliver and finance U.S. health care. Health Law comprehensively treats topics concerns such as the oversight of quality (including the latest developments in patient safety), cost control (including consumer-directed health care), guarantees of adequate access to services, exempt-organization tax issues, transactions and relationships among health care professionals and providers, the Employee Retirement Income Security Act (ERISA), and malpractice litigation. Written without a policy bias to fairly reflect all viewpoints, the book considers legal and ethical issues involving death, human reproduction, medical treatment decision making, and medical research. It also explores the government's efforts to control costs and expand access through Medicare and Medicaid and examines government attempts to police anticompetitive activities, fraud, and abuse. Using carefully edited primary materials and effective classroom-tested problems, the book exposes students to the core issues in health law.

The Law Of Health Care Organization And Finance

Author :
ISBN : PSU:000054549708
Genre : Law
File Size : 24. 85 MB
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A spin-off publication of Health Law: Cases, Materials & Problems, 5th Edition, the text begins with an introduction to fundamental concepts affecting law and policy. The next chapter considers quality control in the health care setting. The following four chapters examine issues central to structuring integrated systems and the organization of health care institutions. It also covers the problem of health care access and cost control issues, with particular attention paid to the ongoing policy debate about the proper role of government and the nation's responsibilities to provide health care for indigent citizens. Examines legal oversight of private health financing, and looks at Medicare and Medicaid.

Health Law 2003

Author : Barry R. Furrow
ISBN : 031414756X
Genre : Law
File Size : 34. 63 MB
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Holding Health Care Accountable

Author : E. Haavi Morreim
ISBN : 0199748942
Genre : Medical
File Size : 84. 81 MB
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Health care in the US and elsewhere has been rocked by economic upheaval. Cost-cuts, care-cuts, and confusion abound. Traditional tort and contract law have not kept pace. Physicians are still expected to deliver the same standard of care -- including costly resources - to everyone, regardless whether it is paid for. Health plans can now face litigation for virtually any unfortunate outcome, even those stemming from society's mandate to keep costs down while improving population health. This book cuts through the chaos and offers a clear, persuasive resolution. Part I explains why new economic realities have rendered prevailing malpractice and contract law largely anachronistic. Part II argues that pointing the legal finger of blame blindly or hastily can hinder good medical care. Instead of "whom do we want to hold liable," we should focus first on "who should be doing what, for the best delivery of health care." When things go wrong, each should be liable only for those aspects of care they could and should have controlled. Once a good division of labor is identified, what kind of liability should be imposed depends on what kind of mistake was made. Failures to exercise adequate expertise (knowledge, skill, care effort) should be addressed as torts, while failures to provide promised resources should be resolved under contract. Part III shows that this approach, though novel, fits remarkably well with basic common law doctrines, and can even enlighten ERISA issues. With extensive documentation from current case law, commentary, and empirical literature, the book will also serve as a comprehensive reference for attorneys, law professors, physicians, administrators, bioethicists, and students.

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