Maintaining Integrity in Times of Scarse Resources

  • H. Jochemsen
  • J. Hoogland
  • J. Polder
Part of the International Library of Ethics, Law, and the New Medicine book series (LIME, volume 26)


Health Care System Medical Practice World View Cost Containment Professional Character 
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  1. 1.
    This term is derived from Williamson O.E., (1989), The economic institutions of capitalism, New York, who introduced the term governance structures. A governance instrument is a measure at the meso-or macro-level taken by the government or other actors in health care to bring about changes in the functioning of the health care system.Google Scholar
  2. 3.
    MacIntyre A. (1981), After virtue. A study in moral theory. London: Duckworth, p.175.Google Scholar
  3. 4.
    For the difference between goal and finality see: Dooyeweerd H. (1953-1958), A new critique of theoretical thought. Amsterdam/Philadelphia: The Presbyterian and Reformed Publishing Company, vol. III p.570, 571.Google Scholar
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    Strijbos S. (ed. 1992), De medische ethiek in de branding-Een keuze uit het werk van Gerrit Arie Lindeboom, Amsterdam,p. 121, 122.Google Scholar
  5. 7.
    See for example Unschuld, PU. Professionalisierung und ihre Folgen. In: Schipperges H, Seidler E, Unschuld PU. (eds). Krankheit, Heilkunst, Heilung. Freiburg/München 1978: p.519,520. Unschuld concludes that the central meaning of the concept of profession is the pursuit of the selfless rendering of a public service and the independence in practicing the work typical for the particular profession.Google Scholar
  6. 9.
    Cf. Puolimatka T. (1989), Moral realism and justification. Helsinki: Suomalainen Tiedeakatemia, p.143–154. Puolimatka defines benevolence as “a normative attitude which regards the well-being of others as intrinsically valuable”, p.144.Google Scholar
  7. 11.
    Figure 2 is based on literature on the characteristics of economic systems. See, for instance Gregory PR, Stuart RC, Comparative Economic Systems. Boston: Houghton Mifflin Company, 1989.Google Scholar
  8. 12.
    In addition to efficiency arguments ideals of liberty are important, cf.:R.E. Moffit.(1994), Personal freedom and responsibility: the ethical foundations of a market-based health care reform. The Journal of Medicine and Philosophy, vol.19:471–81.Google Scholar

Copyright information

© Springer 2005

Authors and Affiliations

  • H. Jochemsen
    • 1
  • J. Hoogland
    • 1
  • J. Polder
    • 1
  1. 1.Lindeboom InstituteEdeNetherlands

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