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Reconstructing a System and Refashioning a Society

Arch Intern Med. 1998;158:2419-2422.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

IN THIS issue of the ARCHIVES, Kuczewski and DeVita¹ present and analyze a case typical of today's managed care environment. It is a complex case that has a number of troubling ethical aspects, as in many ways does their conclusion. In this editorial, I will briefly examine some of the issues that this very troubling case raises. Crafting a method to deal with these issues will inevitably shape how technical medicine is practiced and will also critically affect how ethical problems of medical practice are understood and addressed.

The situation presented in the article by Kuczewski and DeVita—one in which a patient whom, for reasons of cost, the hospital is anxious to transfer to another and lesser facility, a facility that at least the family and possibly the physicians and nurses feel has a less-than-optimal level of care—is not new to medical practice. Patients or their families have often been . . . [Full Text of this Article]

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