医学伦理与医生动机

Medical ethics and physician motivations

Journal of Health Economics · 2024
被引 0
人大 AABS 3

中文导读

用制度经济学框架分析医学伦理,探讨医生支持伦理约束的动机,并解释美国正式伦理长期弱化的原因。

Abstract

This paper provides an institutional economics framework for analyzing medical ethics. An ethical policy partitions the set of physician actions into (un)ethical subsets, with unethical actions then unavailable. Individual physicians' preferences over policies combined with a political process determine equilibrium constraints. I show that physicians' concern for colleagues' patients uniquely motivates their support for ethics which restrict behavior under strong assumptions. Without these assumptions, even identical physicians might ban actions they would otherwise select for reasons varying from protecting patients to differences in the costs of maintaining ethical policies. Interestingly, heightened altruism for colleagues' patients makes the former reasoning less credible. Novel applications for 'Provide Free Care to Physicians' and 'Duty to Treat in a Pandemic' demonstrate: (i) rising physician income can explain long-run weakening of both formal ethics in the United States; and (ii) the duty to treat can deteriorate as fewer physicians are required to improve pandemic outcomes.

医疗伦理医生动机制度经济学伦理政策