AMA, ACP ethics groups study distribution of health care

Medical organizations provide guidance on allocating finite resources.

By Andis Robeznieks, AMNews staff. Aug. 9, 2004.

Discussions on the roles of physicians, insurers, employers and patients in making health care coverage and resource allocation decisions are part of a discussion which is charting the course of medicine as a profession, said Matthew Wynia, MD, director of the AMA Institute for Ethics.

Defining these roles and their ethical responsibilities is the subject of two high-profile papers produced by the AMA and the American College of Physicians. The AMA report was a project of its Ethical Force Program and is set to be published in an upcoming volume of the American Journal of Bioethics. The ACP's paper was produced by its Center for Ethics and Professionalism and appeared in the July 20 issue of the Annals of Internal Medicine.

"I think that the documents are part of an ongoing and evolutionary discussion about what it means to be a doctor and the physician's role in the society," said Dr. Wynia, who was a contributing author of the Ethical Force report. "We're seeing an increasingly frank discussion about dealing with these issues."

The AMA report, "Ensuring Fairness in Health Care Coverage Decisions," calls for the processes of designing and administering health benefits to be transparent, participatory, equitable and consistent, sensitive to value and compassionate.

The ACP report, "Ethics in Practice: Managed Care and the Changing Health Care Environment," is a statement of principles calling for respectful, truthful, fair and compassionate relationships; shared responsibility for stewardship of health care resources; fostering the ethical delivery of effective and efficient care; and informing patients about care and treatment options and the financial issues affecting the provision of care.