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David L. Schiedermayer; John Puma, MD; Steven H. Miles, MD

Arch Intern Med. 1989;149(6):1303-1305.

Abstract
• The ethical and economic aspects of treatment decisions are often intimately entwined. We demonstrate how clinical economic questions were raised in clinical ethics consultations involving three patients: a 49-year-old retarded man who required short-term tube feeding; a 74-year-old man with metastatic prostatic cancer whose relatives disagreed about whether or not he should have surgical treatment; and a 55-year-old man whose health maintenance organization declined to pay for liver transplantation. Ethics consultants can help to clarify financial constraints and to resolve financial conflicts of interest. All physicians must develop the ability to unmask economic issues in medical care.

(Arch Intern Med. 1989;149:1303-1305)

Author Affiliations
From the Department of Medicine and the Center for the Study of Bioethics, Medical College of Wisconsin, Milwaukee (Dr Schiedermayer); the Section of Clinical Ethics, Lutheran General Hospital, Park Ridge, Ill (Dr La Puma); and the Center for Clinical Medical Ethics (Dr Miles) and the Department of Medicine (Dr La Puma), Pritzker School of Medicine, University of Chicago (Ill).

Footnotes
Accepted for publication March 2,1989.

Reprint requests to Center for the Study of Bioethics, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI 53226 (Dr Schiedermayer).

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