PubMed Health⌕ Search

Biomedical subjects

D Callahan

Publications and source records attributed to D Callahan.

At least 37 records · Page 2Linked to original sources
PubMed1999

Medicine and the market: a research agenda.

One of the most important developments in international medicine over the past two decades has been a turn to the market as a way of coping with rising costs and responding to calls for more freedom from government control. A full moral evaluation of the relationship of medicine and the market requires asking a wide range of questions bearing on the meaning and impact of market strategies on the economics of health care and on the clinical and public health outcomes of those strategies. A number of the leading questions are presented and some provisional answers offered.

Biomedical Research↗
PubMed1999

Balancing efficiency and need in allocating resources to the care of persons with serious mental illness.

The care of patients with serious mental illness, for whom a cure is unlikely and costs are high, is difficult to justify using ordinary standards of efficient resource allocation. The author examines the difficulties of using conventional utilitarian, cost-benefit, moral, and political arguments to justify allocation of resources to the care of persons with serious mental illness and offers an alternative approach to this problem based on the goals of medicine. Although care for persons with serious mental illness may not meet the usual standards of efficient health care spending, their treatment is justified by central and long-standing goals of medicine such as relief of pain and suffering and care of those who cannot be cured. This approach suggests that the idea of efficiency in health care spending should be adapted to the goals of medicine rather than making those goals adapt to the idea of efficiency.

Chronic Disease↗
PubMed1998

Managed care and the goals of medicine.

The goals of medicine encompass the relief of pain and suffering, the promotion of health and the prevention of disease, the forestalling of death and the promoting of a peaceful death, and the cure of disease when possible and the care of those who can not be cured. Managed care, as a system of integrated healthcare delivery designed to control costs, is not, in principle, incompatible with the goals of medicine, but in practice it may well be, depending on whether profit is sought, whether the integrity of physicians' medical judgment is protected, and whether government regulations control managed care practices to prevent abuse and to enhance the quality of care.

Goals↗
PubMed1998

Is aging a preventable or curable disease?

The question of whether aging is a disease is old and controverted. Three possible positions are outlined: (i) aging is a natural event, not a disease; (ii) aging is a disease, to be combated by medical knowledge and skills; and (iii) aging, while natural, can be treated as if it is a disease and efforts made to lessen its undesirable impact. The last position seems, de facto, the one that is being pursued by contemporary medicine; however, in such a pursuit, important issues will be raised of intergenerational justice in paying for advances in medicine, and the need to balance the medical goals of care for aged people against other important social needs.

Aging↗
PubMed1998

The future of the medical profession between bioethics and the market: a final comment.

For a variety of historical and professional reasons the field of bioethics has paid little attention to the market. It has tended to treat the market with suspicion or hostility. Now, however, the market must be taken seriously. It has become a world-wide force in health care, and there is every reason to believe it will remain strong in the future. For that reason, it is wise to see what can be taken from the market, rather than simply dismiss it altogether. The market has various aspects: a theory of human nature, a view of human behavior, and an ideological aspect, with proponents stressing the necessary connection between political and market freedom. This article argues that only its view of human behavior should be accepted, particularly the possibility of using incentives, positive and negative, to change behavior. That can be helpful in health care, whereas the market's view of human nature should be rejected.

Bioethics↗
PubMed1995

Managed care in mental health: the ethical issues.

Praise and blame of managed mental health care are on the rise on many fronts, including allegations that it could adversely affect quality of care, access to care, the physician/patient relationship, and informed patient choice. Given the heterogeneity among managed mental health care organizations--each with differing practices--it is difficult to sift the ethically defensible concerns from the indefensible ones. In this paper we identify and examine the different moral concerns about managed mental health care and mark which problems have been addressed or are in need of resolution. We also identify which problems are unique to managed mental health care.

Adolescent↗
PubMed1995

Frustrated mastery. The cultural context of death in America.

The care of dying patients as a problem in the United States cannot be well understood apart from understanding the way in which American culture has responded to the problem of death. This country seems unusual among developed countries in its passion to conquer death, often acting as if death were simply one more disease to be overcome. American medicine has been influenced by this background culture, while adding some idiosyncratic features of its own. A powerful attraction to technology, a fear of malpractice litigation, and a fundamental ambivalence about the response physicians should have to death help to explain why the care of dying patients has been so difficult, so controversial, and so troubling to both the medical and the lay communities.

Attitude to Death↗
PubMed1994

[Euthanasia in the United States].

In the West, efforts to legalize active euthanasia and assisted suicide go back at least a century. Debates have emerged over the past two decades in a number of countries, however. What are the principal arguments put forward in favor of it? What development in contemporary medicine, and contemporary culture, might account for an increasingly favorable attitude toward euthanasia? What kind of efforts are being developed to stop or to impede the euthanasia movement?

Ethics, Medical↗