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July 1, 1992

Must the Law Assure Ethical Behavior?

Author Affiliations

From the Executive Vice President, American Medical Association, Chicago, Ill.

JAMA. 1992;268(1):98. doi:10.1001/jama.1992.03490010100038

Success and progress always cause problems! Until fairly recently, the image of medicine was of a practitioner and patient working together in a spirit of trust and responsibility. Even with the advent of group practice, this same image persisted. Health care options, limited by a paucity of science, were simple and everyone understood the transaction. Then scientific progress quickened and the options for diagnosis and treatment exploded. Along with this began the isolation, through insurance, of both patient and physician from the economic consequences of their decisions. Following quickly was the escalation in costs of care beyond what some in society considered reasonable. Cost (really price) control was started, the intention being to reduce the volume of care given by reducing individual reimbursement: a shaky hypothesis at best.

Given this scenario, it is not surprising that physicians would look for ways to enhance the availability of all this burgeoning technology