A Revered Ethicist Argues For Restricting Direct-Pay Practices

DrRich | August 11th, 2011 - 5:30 pm


DrRich, in his last post, attempted to show why a direct-pay medical practice is the only remaining pathway by which PCPs may preserve the classic doctor-patient relationship, and for patients to assure themselves that they are working with a doctor who at least has the prerogative to actually place their individual interests first, above all those other powerful, ruthless, contrary interests, which are striving to control the behaviors of their doctors.

He attempted to show this by making an argument founded in the principles of medical ethics.

As it happens, one of today’s best-known medical ethicists, at about the same time, was telling doctors just the opposite. Arthur Caplan, at the University of Pennsylvania Center for Bioethics, published this advice for doctors at Medscape.com. Here is the meat of Dr. Caplan’s admonition:

“No matter how you look at it, if you allow providers to buy out, you are going to leave other patients with lower-quality care, and you are going to burden the remaining primary care practitioners (who don’t take the concierge route) with more work.”

DrRich has two comments.

First, this argument against direct-pay practices is based solely on the goal of social justice.

DrRich has not been shy about expressing his disdain for the views of your typical, modern medical ethicist. Most of these individuals today embrace the utilitarian camp of medical ethics, wherein formerly revered niceties based on ethical precepts (like the classic doctor-patient relationship) must take a back seat to the goals of social justice. And where social justice is concerned the ends justify the means.

Achieving “social justice,” of course, always and inherently requires a powerful Central Authority which has the muscle to make sure that all of the benefits of life are distributed in a just and fair way. What is just and fair, of course, is to be determined by groups of sanctioned experts, a sort of expert class with guns. These will determine who gets what, when and how.

So once again a member of the group of sanctioned experts, who will determine how things are to be, comes right out and tells us: a doctor who embraces the kind of medical practice where a doctor’s only responsibility is to the needs of his/her patient is behaving unethically.

Second, DrRich calls your attention to the most interesting and revealing phrase uttered by Dr. Caplan: “If you allow practitioners to buy out. . .”

What Dr. Caplan is saying is that doctors must not be allowed to establish direct pay practices. It must not be left to them. We must prevent them from doing so. That is, it must be made illegal.

He is laying out a formal ethical argument for doing what DrRich has been warning his readers, over and over again, the Progressives are bound and determined to do: to make it illegal to sell medical services directly to individuals, and for individuals to purchase medical services with their own money. You can only get your healthcare when, how and from whom the Central Authority says.

The message won’t get much more explicit than this, dear readers. DrRich begs you to take heed before it is too late.

4 Responses to “A Revered Ethicist Argues For Restricting Direct-Pay Practices”

  1. pj says:

    si vis pacem, para bellum.

  2. Doc99 says:

    The Road to Serfdom was paved by ethicists.

  3. This was one of the most objectionable features of Hillarycare.

  4. Excellent example. I must call this to the attention of a friend who is an ethicist.

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