Managed care ethics: an emergency?

The rapid expansion of cost-consciousness and managed care into the medical marketplace has challenged the autonomy of physicians and patients. These challenges have taken a variety of forms, including limitations on reimbursement and restrictions on the amount and type of emergency care patients may receive. Challenges aside, the economic agenda of managed care must not threaten the primacy of patient welfare. The fidelity of the emergency physician-patient relationship and the integrity of the medical profession hangs in the balance.