Is “Ethical Managed Care” an Oxymoron?

Abstract

Ethical issues involved in providing managed health and mental health care have received much attention from policymakers, the helping professions, consumer groups, and the popular press. Many contend that managed care is inherently unethical, given its emphasis on controlled access to needed resources. A less visible but no less fervent minority contends that managed care need not lead to ethical compromise and, in fact, is at least as ethically justifiable a means of providing care as was the unregulated fee-for-service system. The author reviews the literature, presents arguments on both sides of the question, and offers a list of principles, characteristics, and resources by which ethical managed care might be identified.