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In this paper, I aim to demonstrate that the consequences of the current United States health insurance scheme on both physician and patient autonomy is dire. So dire, in fact, that the only moral solution is something other than what we have now. The United States healthcare system faces much criticism at present. But my focus is particular: I am interested in the ways in which insurance interferes with physician and patient autonomy. (I do not consider The Affordable Care Act much of a change in this aspect of the system, for it still relies heavily on private insurance, albeit often subsidized.) I will argue in favor of an expansion of the traditional conception of what I call “medical autonomy” or “healthcare autonomy” and the usual role it plays in bioethical discussions. More generally, I show that in morally designing or evaluating any healthcare system, serious attention should be paid to how this system helps foster what I call active autonomy.
KeywordsInsurance Healthcare Autonomy Patient autonomy
- Aristotle. (2009). The nicomachean ethics. In W. D. Ross & L. Brown (Eds.). Oxford: Oxford University Press.Google Scholar
- Beauchamp, T. L., & Childress, J. F. (2001). Principles of biomedical ethics (5th ed.). New York: Oxford University Press.Google Scholar
- Bernard, T. S. (October 18, 2013). Out of network, not by choice, and facing huge health bills. The New York Times. http://www.nytimes.com/2013/10/19/your-money/out-of-network-not-by-choice-and-facing-huge-health-bills.html. Accessed 6 April 2017.
- Buss, S. (2016). Personal autonomy. In E. N. Zalta (Ed.), The Stanford encyclopedia of philosophy (Winter 2016 ed.). https://plato.stanford.edu/archives/win2016/entries/personal-autonomy/. Accessed 5 July 2018.
- Centers for Disease Control. (2016). U.S. public health service syphilis study at Tuskegee. Centers for Disease Control and Prevention. https://www.cdc.gov/tuskegee/timeline.htm. Accessed 3 April 2017.
- Centers for Disease Control and Prevention. (2017). The Tuskagee timeline. https://www.cdc.gov/tuskegee/timeline.htm. Accessed 5 July 2018.
- Chapin, C. (2015b). Background: Physcians choose the insurance company model, late 19th century-1940s. In Ensuring America's health: The public creation of the corporate healthcare system (pp. 10–36). Cambridge: Cambridge University Press.Google Scholar
- Connecticut Insurance Department. (2018). Faq's regarding repairs to your vehicle. http://ct.gov/cid/cwp/view.asp?a=1272&Q=483962&pp=12&n=. Accessed 5 July 2018.
- Jones, J. (1993). Bad blood: The Tuskegee syphilis experiment, new and expanded edition. New York: Free Press.Google Scholar
- Kaiser Permanente. (n.d.). Why Kaiser Permanente? https://individual-family.kaiserpermanente.org/healthinsurance/why-kaiser-permanente/affordable-health-insurance. Accessed 5 July 2018.
- Sack, K. (March 25, 2010). As Medicaid payments shrink, patients are abandoned. The New York Times. http://www.nytimes.com/2010/03/16/health/policy/16medicaid.html. Accessed 6 April 2017.
- The Doctor. (1991). Directed by Randa Haines. Performed by William Hurt, Christine Lahti, and Elizabeth Perkins (1991; Touchstone Pictures; 2004), DVD.Google Scholar
- Tyson, P. (2001). The hippocratic oath. Nova. http://www.pbs.org/wgbh/nova/body/hippocratic-oath-today.html. Accessed 11 July 2018.