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Cost constraints as a malpractice defense.

¹College of Medicine, University of Tennessee, Memphis.

The Hastings Center Report

|February 1, 1988

Summary

Physicians face cost pressures conflicting with patient care duties. The law should consider adjusting standards of care based on patient finances, using a "rebuttable presumption" legal concept.

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Area of Science:

Medical ethics
Health law
Healthcare economics

Background:

Physicians experience increasing fiscal responsibilities due to cost-containment measures.
These financial pressures can create ethical conflicts with their fiduciary duty to provide optimal patient care.

Purpose of the Study:

To explore the legal and ethical implications of adjusting standards of care based on patient financial resources.
To propose a legal framework for managing the conflict between cost containment and patient welfare.

Main Methods:

Analysis of legal principles governing the standard of care in medicine.
Examination of the concept of "rebuttable presumption" in legal contexts.
Discussion of ethical considerations in healthcare provision under financial constraints.

Main Results:

The traditional uniform standard of care may be challenged by economic realities in healthcare.
The legal concept of "rebuttable presumption" offers a potential mechanism to adapt care standards.
Allowing adjustments to the standard of care based on financial resources raises significant ethical and legal questions.

Conclusions:

Reconceiving the uniform standard of care using "rebuttable presumption" is proposed to address cost-containment conflicts.
Further legal and ethical debate is needed on adapting care standards to patient financial status.
Balancing fiscal responsibility with the fiduciary commitment to patients requires innovative legal approaches.

Keywords:

Health Care and Public Health Legal Approach Professional Patient Relationship

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