Ethics and health care: the next 20 years

Shifts in moral values in society as they pertain to the future of health care for the next 20 years are discussed. Even though people tend to think that moral dilemmas linger on forever, any number of moral issues that were once hotly debated are now resolved. The trends in health care since World War II--greater access to health care, continual development of new therapies, and elimination of disease and illness--have produced several moral dilemmas. Questions about what society can afford, rationing of health care, and the quality of life now abound; these will directly affect progress in health care in the next 20 years. Expensive technologies that benefit only a few will likely be scrapped in favor of emphasis on low-cost therapies with broader applications. Although complicated, a cost-benefit analysis and exercise should be undertaken to decide whether advances are worth the investments. There have been several shifts in moral values of society that will affect health care over the next couple of decades. Among these are the resurgence of emphasis on the common good (rather than the rights of individuals), movement away from emphasis on rules and principles and toward development of character and virtue, greater sobriety about the negative potential of new technologies, increased group medical practices, and changing ideas about the moral implications of chronic diseases and about the relative roles of the individual and society in improving health.(ABSTRACT TRUNCATED AT 250 WORDS)