Physician competency: whose responsibility?

Article Abstract:

The Association of American Medical Colleges, along with the American Medical Association (AMA), recently sponsored a conference entitled ''Physician competency: whose responsibility?''. The conference focused upon educational methods and government monitoring of physician activity, and left the ethical question unanswered. To answer this question, another needs to be asked: what is the physician's purpose? It is the goal of medicine to maintain health and prevent disease, and to do this the physician must make decisions about the patient's physiological and psychological functions. Because medical and health decisions can deeply affect a patient's life, the physician must ask herself if what she is doing is morally good for the patient. The physician is responsible for acquiring the available medical knowledge, developing the competency to apply this knowledge, and discerning where the focus will be with each patient. To do this effectively requires personal dedication to helping people attain a better life. The medical communities are also responsible for the competency of their members, in medical schools, hospitals, and professional organizations. Evaluation of competency is still necessary, as accountability is an important motivator for developing competency. Physicians are primarily responsible for evaluating the competency of other physicians; but this practice is being questioned, and evaluation by ''lay people'', who make up the bulk of the health care recipients, is being considered. Evaluation boards made up of physicians and lay people would focus on evaluating practical results rather than speculative knowledge. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physicians, Medical professions

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Is business incompatible with health care?

Article Abstract:

Having medicine be a profit-making business can have a deleterious impact on what should be its primary goal, to benefit the patient's health. In addressing its financial status, the medical profession has had to cut costs to increase profits. This has resulted in higher costs to consumers, along with less comprehensive care. Physicians are often restrained from offering the care they used to, and again, patients do not receive the care they might expect. One such trend, early hospital discharge, has contributed to the growing perception that medicine is more concerned with profits than patients. The patients are not the only frustrated group, as health care professionals also feel frustrated over the pressure to forego what was once standard protocol. Still, the attitudes that business has brought to health care need moral evaluation. Even though the President's Commission on bioethics states that ''society has an obligation to ensure equitable access to adequate care'', the health care industry still offers many specialty services, such as ''tummy tucks'' and various cosmetic implants, while the basic health needs of many people go unmet. Business is not in and of itself an immoral activity, but when the health care business has a bottom line of profitability, the buyer needs to beware. Business and health care are compatible as long as the business ethics of meeting a social need, offering a moral service, telling the truth, keeping promises, and providing safe and effective care for all people are followed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Economic aspects, Professional ethics, Health services administration

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Withdrawal of treatment: ethical issues

Article Abstract:

Health caregivers increasingly face the ethical issue of withdrawing or withholding treatment from patients. The patient's wishes should determine when the goal of medical interventions changes from supporting life to providing comfort. The patient's needs should guide the administration of measures to alleviate discomfort. Patients must define what their needs are and how they are addressed, and caregivers must act out of duty and compassion.

Terminal care, Practice guidelines (Medicine), Resuscitation

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