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February 25, 1983

The Battle for Hospital Privileges: II. Ensuring Fairness and Rational Standards of Decision

Author Affiliations

From the Office of the General Counsel, American Medical Association. For further information and reprints, write to the Office of the General Counsel, American Medical Association, 535 N Dearborn St, Chicago, IL 60610.

JAMA. 1983;249(8):1061-1062. doi:10.1001/jama.1983.03330320059035

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IN RECENT years, the facilities of the modern hospital have become increasingly scarce but crucial resources to the physician. As a consequence, the hospital institution has become an arena in which bitter struggles for access to essential technologies and services have been waged. Often these conflicts reflect the tensions between the economic and social interests of individual physicians and those of the institution itself. Their resolution affects public interests as well, leading some courts to conclude that even the staff privilege decisions of private hospitals should be subject to judicial oversight (JAMA 1983; 249:526-527). Traditionally, the standards to which staff selection decisions have been subjected are drawn from substantive and procedural "due process" principles.

Substantive Due Process  Whether derived from federal constitutional law or from state common law principles, substantive due process requires that the standards by which applicants are evaluated be reasonable, in that they comport with the legitimate