Medicine and Society: Clinical Decisions and Societal Values

Medicine and Society: Clinical Decisions and Societal Values

Medicine and Society: Clinical Decisions and Societal Values

Medicine and Society: Clinical Decisions and Societal Values

Excerpt

Medicine and Society: Clinical Decisions and Societal Values reflects the theme of the Cornell University Medical College Third Conference on Health Policy, a series made possible by an anonymous gift of $50 million to the Medical College that specified the development of a program on health policy as part of that gift. The intent of the conferences has been to probe in depth major issues that have the potential of altering in fundamental ways the structure of medicine—how it is practiced, what it does, and whom it benefits.

The first conference, held in 1985 ( The U.S. Health Care System: A Look to the 1990s ), considered how the health care delivery system was changing in the 1980s and how these changes in an increasingly market‐ oriented environment threatened access by the poor to health care. The conference that followed in 1986 focused on two conflicting developments: the continuing large increase in the number of physicians in proportion to the population and the development of new, managed health care systems and their influence on medical practice ( From Physician Shortage to Patient Shortage: The Uncertain Future of Medical Practice ). This year's conference focuses on new frontiers of clinical medicine and the dilemmas they pose for society and the profession.

As before, the backbone of the conference consisted of six specially prepared papers that provided the points of departure for the two-day discussion. They are contained in this volume together with an introductory chapter and summary of the proceedings written by the conference chairman.

The Third Conference builds upon the themes of its predecessors. Its focus is derived from those discussions that identified as a fundamental issue the translation of societal values into health care objectives and the formulation of mechanisms by which these objectives could guide the process of making clinical decisions. That is, how should society or the individual physician make clinical decisions regarding individual patient care that are consistent with societal goals and values? The authors of the basic papers seem to agree on several principles: First, all persons, regardless of individual resources, should be provided access to something that is defined as "essential health care"; second, care should be . . .

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