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Diagnosing for administrative purposes: some ethical problems.

H D Lomas, J D Berman

    Social Science & Medicine (1982)
    |January 1, 1983
    PubMed
    Summary
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    Medical evaluations for benefits, without therapeutic intent, create ethical dilemmas for physicians. Distinguishing administrative from therapeutic diagnosis is a crucial first step in addressing these complex medical ethics issues.

    Area of Science:

    • Medical Ethics
    • Social Medicine
    • Health Policy

    Background:

    • Medical evaluations for substantial benefits often lack therapeutic intent.
    • This absence of therapeutic goals challenges traditional medical values and creates ethical quandaries.
    • Physicians in these roles face unique pressures and potential conflicts of interest.

    Purpose of the Study:

    • To explore the ethical challenges faced by physicians performing medical evaluations for benefit determination.
    • To examine the conflict between administrative assessment and therapeutic goals in medicine.
    • To propose a distinction between diagnostic purposes for administrative versus therapeutic aims.

    Main Methods:

    • Conceptual analysis of medical ethics in administrative evaluations.
    Keywords:
    Bioethics and Professional EthicsProfessional Patient Relationship

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  • Discussion of the physician's role and accountability in non-therapeutic assessments.
  • Exploration of the 'double agent' dilemma and its impact on physicians.

    • Main Results:

    • Performing medical evaluations without therapeutic intent compromises ethical medical practice.
    • Physicians may prioritize personal values over professional ethics due to the non-therapeutic context.
    • The adversarial nature of benefit assessments creates a 'double agent' conflict for certifying physicians.

    Conclusions:

    • A clear distinction between administrative and therapeutic diagnosis is essential for ethical clarity.
    • The 'ethics of reality,' driven by life-and-death consequences, can override other ethical considerations.
    • Addressing these ethical issues requires acknowledging the unique pressures on physicians in administrative roles.