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HEC Forum

, Volume 30, Issue 3, pp 297–318 | Cite as

Autonomy-Centered Healthcare

  • Maura Priest
Article
  • 283 Downloads

Abstract

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.

Keywords

Insurance Healthcare Autonomy Patient autonomy 

References

  1. Aristotle. (2009). The nicomachean ethics. In W. D. Ross & L. Brown (Eds.). Oxford: Oxford University Press.Google Scholar
  2. Barondess, J. A. (1998). Care of the medical ethos: Reflections on social darwinism, racial hygiene, and the holocaust. Annals of Internal Medicine, 129(11), 891–898.CrossRefGoogle Scholar
  3. Beauchamp, T. L., & Childress, J. F. (2001). Principles of biomedical ethics (5th ed.). New York: Oxford University Press.Google Scholar
  4. 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.
  5. Bishop, T. F., Press, M. J., Keyhani, S., & Pincus, H. A. (2014). Acceptance of insurance by psychiatrists and the implications for access to mental healthcare. JAMA Psychiatry, 71(2), 176–181.CrossRefGoogle Scholar
  6. 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. 
  7. Centers for Disease Control. (2016). U.S. public health service syphilis study at Tuskegee. Centers for Disease Control and Preventionhttps://www.cdc.gov/tuskegee/timeline.htm. Accessed 3 April 2017.
  8. Centers for Disease Control and Prevention. (2017). The Tuskagee timeline. https://www.cdc.gov/tuskegee/timeline.htm. Accessed 5 July 2018.
  9. Chapin, C. F. (2015a). Ensuring America’s health: The public creation of the corporate healthcare system. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
  10. 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
  11. 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.
  12. Jones, J. (1993). Bad blood: The Tuskegee syphilis experiment, new and expanded edition. New York: Free Press.Google Scholar
  13. Lerner, B. H., & Rothman, D. J. (1995). Medicine and the Holocaust: Learning more of the lessons. Annals of Internal Medicine, 122(10), 793–794.CrossRefGoogle Scholar
  14. Martinelli, C. (2006). Would rational voters acquire costly information? Journal of Economic Theory, 129(1), 225–251.CrossRefGoogle Scholar
  15. McInroy, A. (2005). Blood transfusion and Jehovah’s witnesses: The legal and ethical issues. British Journal of Nursing, 14(5), 270–274.CrossRefGoogle Scholar
  16. Migden, D. R., & Braen, G. R. (1998). The Jehovah’s Witness blood refusal card: Ethical and medicolegal considerations for emergency physicians. Academic Emergency Medicine, 5(8), 815–824.CrossRefGoogle Scholar
  17. Muramoto, O. (1998). Bioethics of the refusal of blood by Jehovah’s Witnesses: Part 1. Should bioethical deliberation consider dissidents’ views? Journal of Medical Ethics, 24(4), 223–230.CrossRefGoogle Scholar
  18. 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.
  19. The Doctor. (1991). Directed by Randa Haines. Performed by William Hurt, Christine Lahti, and Elizabeth Perkins (1991; Touchstone Pictures; 2004), DVD.Google Scholar
  20. Tyson, P. (2001). The hippocratic oath. Nova. http://www.pbs.org/wgbh/nova/body/hippocratic-oath-today.html. Accessed 11 July 2018.
  21. Woolley, S. (2005). Jehovah’s witnesses in the emergency department: What are their rights? Emergency Medicine Journal, 22(12), 869–871.CrossRefGoogle Scholar

Copyright information

© Springer Nature B.V. 2018

Authors and Affiliations

  1. 1.Department of PhilosophyArizona State UniversityTempeUSA

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