No Margin, No Mission: Health Care Organizations and the Quest for Ethical Excellence

by Steven D. Pearson, James Sabin, Ezekiel J. Emanuel

Overview

Can the ethical mission of health care survive among organizations competing for survival in the marketplace? On this question hinges not only the future of health care in the US, but that of the health care systems of all advanced countries. This book presents both an analytic framework and a menu of pragmatic answers. The team of authors, physician-ethicists from Harvard Medical School and the National Institutes of Health, worked with a consortium of health care organizations to explore some of the most challenging dilemmas in health care today: How can health plans determine medical necessity in a way that ensures quality care, controls costs, and builds trust with patients and physicians? What are the strategies for caring for vulnerable populations that meet their special neds without dramatically increasing costs? To answer these and other similar questions the authors blend ethical analysis with real-world example. The outcome is a rich analysis of the ethical challenges facing health care organizations, combined with tangible examples of exemplary methods to address these challenges. This book will help health care leaders, regulators, and policy makers incorporate exemplary practices, and the underlying themes they embody, into the very heart and soul of health care organizations.

Product Details

ISBN-13:	9780190289294
Publisher:	Oxford University Press
Publication date:	08/21/2003
Sold by:	Barnes & Noble
Format:	eBook
File size:	809 KB

About the Author

both at Harvard Medical School and Harvard Pilgrim Health Care

Warren G. Magnuson Clinical Center, National Institutes of Health

Table of Contents

1.	Virtue Among the Ruins?	1
2.	Evidence-based Ethics and the BEST Project	13
3.	Organizational Ethics	25
4.	Consumer Empowerment	45
5.	Medical Necessity, Coverage Decisions, and Medical Policy	67
6.	The Care of Vulnerable Populations	97
7.	Community Benefits	117
8.	The Confidentiality of Personal Health Information	139
9.	The Perennial Ethical Challenges of Health Care in Competitive Systems	153
	References	167
	Index	173

Editorial Reviews

"This is an informative, interesting and...inspirational examination of the ethical obligations, commitments and strategies of a number of health care organizations in the U.S...No Margin, No Mission serves as a powerful counterargument to all those who claim ethical reasoning and analysis have no "real-world" relevance for shaping a health care organization's business policy and practice."—Journal of Health Care for the Poor and Undeserved

From the Publisher