University of Toronto, Toronto, Ontario, Canada.
J Med Philos. 2020 Jan 10;45(1):86-104. doi: 10.1093/jmp/jhz029.
Medical ethics has become an important and recognized component of physician training. There is one area, however, in which medical students receive little guidance. There is practically no discussion of the financial aspects of medical practice. My objective in this paper is to initiate a discussion about the moral dimension of physician billing practices. I argue that physicians should expand their conception of professional responsibility in order to recognize that their moral obligations toward patients include a commitment to honest and forthright billing practices. I argue that physicians should aspire to a standard of clinical accuracy-not legal adequacy-in describing their activities. More generally, physicians should strive to promote an integrity-based professional culture, first and foremost by stigmatizing rather than celebrating creative billing practices, as well as condemning the misguided sense of solidarity that currently makes it taboo for physicians to criticize each other on this score.
医学伦理学已成为医师培训的一个重要且公认的组成部分。然而，有一个领域，医学生几乎得不到任何指导。实际上，几乎没有讨论医疗实践的财务方面。我在本文中的目的是发起一场关于医生计费实践道德层面的讨论。我认为，医生应该扩大他们对专业责任的概念，以认识到他们对患者的道德义务包括对诚实和坦率的计费实践的承诺。我认为，医生应该追求临床准确性的标准，而不是法律上的充分性，来描述他们的活动。更一般地说，医生应该努力促进基于诚信的专业文化，首先要做的是谴责而不是赞扬创造性的计费实践，以及谴责目前在这方面使医生不敢相互批评的错误团结感。
