POWER, INTEGRITY, AND TRUST IN THE MANAGED PRACTICE OF MEDICINE: LESSONS FROM THE HISTORY OF MEDICAL ETHICS

• Published in: Social philosophy & policy Vol. 19; no. 2; pp. 180 - 211
• Main Author: McCullough, Laurence B.
• Format: Journal Article
• Language: English
• Published: New York, USA Cambridge University Press 01.07.2002
• Subjects: Beneficence; Bioethics; Biomedicine; Conflict of Interest; Delivery of Health Care - economics; Delivery of Health Care - ethics; Delivery of Health Care - history; Entrepreneurship; Ethics; Ethics, Institutional; Ethics, Medical - history; Health care; Health Care Rationing - ethics; Health Care Rationing - history; Health Care Reform - ethics; Historical Development; History of medicine; History, 18th Century; History, 20th Century; Humanities; Humans; Innovations; Integrity; Intellectual development; Managed Care Programs - ethics; Managed Care Services; Medical ethics; Medicare - history; Medicine; Morality; Paternalism; Patients; Philosophy; Physician's Role; Physicians; Physicians - economics; Policy studies; Power; Power (Psychology); Prospective Payment System; Prospective payment systems; Regulation; Research subjects; Resource Allocation - ethics; Social Justice; Social policy; Society; Sociology, Medical; Syphilis; Trust; United Kingdom; United States; United States > US; Bioethics and Professional Ethics; Analytical Approach; Health Care and Public Health
• ISSN: 0265-0525; 1471-6437
• DOI: 10.1017/S0265052502192089

Bioethics as a field began some years before it was finally named in the early 1970s. In many ways, bioethics originated in response to urgent matters of the moment, including the controversy over disconnecting Karen Quinlan's respirator, the egregious paternalism of Donald Cowart's doctors in the famous “Dax” case, the abuse of research subjects in the notorious Tuskegee Syphilis Study, and the need to devise an intellectual framework for the development of federal regulations to protect human subjects of research. The phrase “new and unprecedented” became a common description of the topics and issues to which people who later came to be called “bioethicists” responded. It should come as no surprise that bioethics and its practitioners soon came to the self-understanding that their work was new and unprecedented, much as the innovations of biomedical science and their clinical applications were thought to be.