Business ethics and health care: the re-emerging institution-patient relationship

Managed care poses a challenge to the traditional conceptualization of medicine and of the physician-patient relationship. People have evaluated the merits of managed care by focusing upon the way its incentives alter the relationship between physician and patient. However, this misses the key to rightly evaluating MCOs. To address the ethics of MCOs one should focus on the institution-patient relationship, and this has not been sufficiently addressed in the literature. I will address this relationship here and show how the institution-patient relationship has evolved, why it has become increasingly prominent, and why we must move beyond business ethics for rightly understanding it.