Illingworth P
Department of Philosophy and Religion, Northeastern University, Boston, Massachusetts 02115, USA.
J Med Philos. 2000 Feb;25(1):62-76. doi: 10.1076/0360-5310(200002)25:1;1-V;FT062.
I argue that because bluffing, puffing, and spinning are features of corporate life, they are likely to characterize the doctor-patient relationship in managed care medicine. I show that managed-care organizations (MCOs) and the physicians who contract with them make liberal use of puffing and spinning. In this way, they create a context in which it is likely that patients will also use deceptive mechanisms. Unfortunately, patients risk their health when they deceive their doctors. Using the warranty theory of truth I argue that although bluffing may be ethical in business because all participants agree to it and business has not warranted truth-telling, it is not ethical in a medical context because physicians and MCOs have warranted truth-telling and the quality of medical care depends on it.
我认为，由于虚张声势、夸大吹嘘和歪曲事实是企业生活的特征，它们很可能也会成为管理式医疗中医患关系的特点。我指出，管理式医疗组织（MCO）以及与之签约的医生大量使用夸大吹嘘和歪曲事实的手段。通过这种方式，他们营造了一种环境，在这种环境下患者很可能也会使用欺骗手段。不幸的是，患者欺骗医生时会危及自身健康。运用真理的保证理论，我认为，虽然在商业中虚张声势可能是合乎道德的，因为所有参与者都认可它，而且商业并未保证讲真话，但在医疗环境中这是不道德的，因为医生和管理式医疗组织保证了讲真话，而医疗服务的质量取决于此。
