Ethics

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The View From 30,000 Feet: The Intersection of Medicine, Ethics and Money

(Getty Images)

(Getty Images)

As we’re barreling along toward Jan. 1 and the full implementation of Obamacare, it seems that questions of ethics are embedded in just about every discussion of the practice of medicine and how it will change in the coming years. San Francisco’s Commonwealth Club asked me to explore the issue recently by moderating a discussion featuring three prominent Bay Area physicians that the club had invited to participate.

The formal title of the event was “Improving the Ethics and Practice of Medicine,” but pretty quickly money came right into play.

“We have to come up with the best possible distribution of those resources, so we do the greatest good for the greatest number.”
Dr. Josh Adler, chief medical officer of UCSF, started off by talking about the “age-old principle in care of patients”: Do no harm. And he spoke of patient safety. But then he got right into the cost of health care. We don’t have unlimited resources, ranging from doctors and nurses to hospital beds, he pointed out. “We have to come up with the best possible distribution of those resources, so we do the greatest good for the greatest number.”

He talked about “appropriate stewardship” of limited resources in considering both the health of the individual and the health of broader populations. Continue reading