53 found
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  1.  23
    The Clinical Investigator as Fiduciary: Discarding a Misguided Idea.E. Haavi Morreim - 2005 - Journal of Law, Medicine and Ethics 33 (3):586-598.
    One of the most important questions in the ethics of human clinical research asks what obligations investigators owe the people who enroll in their studies. Research differs in many ways from standard care - the added uncertainties, for instance, and the nontherapeutic interventions such as diagnostic tests whose only purpose is to measure the effects of the research intervention. Hence arises the question whether a physician engaged in clinical research has the same obligations toward research subjects that he owes his (...)
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  2.  30
    The Clinical Investigator as Fiduciary: Discarding a Misguided Idea.E. Haavi Morreim - 2005 - Journal of Law, Medicine and Ethics 33 (3):586-598.
    One of the most important questions in the ethics of human clinical research asks what obligations investigators owe the people who enroll in their studies. Research differs in many ways from standard care - the added uncertainties, for instance, and the nontherapeutic interventions such as diagnostic tests whose only purpose is to measure the effects of the research intervention. Hence arises the question whether a physician engaged in clinical research has the same obligations toward research subjects that he owes his (...)
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  3.  21
    Enough Wiggle RoomBalancing Act: The New Medical Ethics of Medicine's New Economics.David C. Hadorn & E. Haavi Morreim - 1992 - Hastings Center Report 22 (6):43.
    Book reviewed in this article: Balancing Act: The New Medical Ethics of Medicine's New Economics. By E. Haavi Morreim.
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  4.  50
    Litigation in Clinical Research: Malpractice Doctrines Versus Research Realities.E. Haavi Morreim - 2004 - Journal of Law, Medicine and Ethics 32 (3):474-484.
    Human clinical research trials, by which corporations, universities, and research scientists bring new drugs, devices, and procedures into the practice and marketplace of medicine, have become a huge business. The National Institutes of Health doubled its spending over the past five years, while in the private sector the top twenty pharmaceutical companies have more than doubled their investment in research and development over a roughly comparable period. To date, some twenty million Americans have participated in clinical research trials that now (...)
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  5.  13
    Litigation in Clinical Research: Malpractice Doctrines versus Research Realities.E. Haavi Morreim - 2004 - Journal of Law, Medicine and Ethics 32 (3):474-484.
    Human clinical research trials, by which corporations, universities, and research scientists bring new drugs, devices, and procedures into the practice and marketplace of medicine, have become a huge business. The National Institutes of Health doubled its spending over the past five years, while in the private sector the top twenty pharmaceutical companies have more than doubled their investment in research and development over a roughly comparable period. To date, some twenty million Americans have participated in clinical research trials that now (...)
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  6.  30
    Taking a lesson from the lawyers: Defining and addressing conflict of interest.E. Haavi Morreim - 2011 - American Journal of Bioethics 11 (1):33 - 34.
  7.  11
    Holding Health Care Accountable: Law and the New Medical Marketplace.Frances H. Miller & E. Haavi Morreim - 2003 - Hastings Center Report 33 (2):46.
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  8. A Dose of Our Own Medicine: Alternative Medicine, Conventional Medicine, and the Standards of Science.E. Haavi Morreim - 2003 - Journal of Law, Medicine and Ethics 31 (2):222-235.
    The discussion about complementary and alternative medicine is sometimes rather heated. “Quackery!” the cry goes. A large proportion “of unconventional practices entail theories that are patently unscientific.” “It is time for the scientific community to stop giving alternative medicine a free ride. There cannot be two kinds of medicine — conventional and alternative. There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work.” “I submit that (...)
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  9.  23
    Profoundly Diminished Life The Casualties of Coercion.E. Haavi Morreim - 1994 - Hastings Center Report 24 (1):33-42.
    The “futility debate” turns on intractable conflicts of deeply held beliefs about the value of life. It raises practical moral dilemmas of how best to permit parties to honor their own values without coercing unwilling others.
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  10.  20
    Of rescue and responsibility: Learning to live with limits.E. Haavi Morreim - 1994 - Journal of Medicine and Philosophy 19 (5):455-470.
    Universal access to health care is still a dream rather than a reality in the United States. This is partly because a rule of rescue, by impelling us to help people in need, urges us to ignore the limits of our health care policies wherever those limits would adversely affect a given individual. As the rule of rescue undermines whatever limits we set on health care entitlements, it can thwart the cost containment so essential to expanding access. Rather than accept (...)
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  11.  36
    A Dose of Our Own Medicine: Alternative Medicine, Conventional Medicine, and the Standards of Science.E. Haavi Morreim - 2003 - Journal of Law, Medicine and Ethics 31 (2):222-235.
    The discussion about complementary and alternative medicine is sometimes rather heated. “Quackery!” the cry goes. A large proportion “of unconventional practices entail theories that are patently unscientific.” “It is time for the scientific community to stop giving alternative medicine a free ride. There cannot be two kinds of medicine — conventional and alternative. There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work.” “I submit that (...)
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  12.  17
    High‐Profile Research and the Media: The Case of the Abio‐Cor Artificial Heart.E. Haavi Morreim - 2004 - Hastings Center Report 34 (1):11-24.
    Public discussion of new medical trials is desirable, but not moment‐by‐moment disclosure of patients' ups and down. Nor is such disclosure necessary: the public is not entitled to all information about a trial as soon as it is available. What should be given the press, and what withheld, cannot be decided without appreciating the surprising number and intricate interrelations of the parties' needs and interests.
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  13.  6
    Holding Health Care Accountable: Law and the New Medical Marketplace.E. Haavi Morreim - 2001 - Oup Usa.
    Tort and contract law have not kept pace with the stunning changes in medicine's economics. Physicians are still expected to deliver the same standard of care to everyone, regardless whether it is paid for. Health plans increasingly face liability for unfortunate outcomes, even those stemming from society's mandate to keep costs down while improving population health. This book sorts through the chaos. After reviewing the inadequacies of current tort and contract law, Morreim proposes that an intelligent assignment of legal liability (...)
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  14.  13
    Cost Containment: Challenging Fidelity and Justice.E. Haavi Morreim - 1988 - Hastings Center Report 18 (6):20-25.
    The federal government's introduction in 1983 of DRG‐based reimbursement for Medicare patients shook the entire health care industry into the vigorous and dramatic cost containment efforts which today are reshaping health care in America.
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  15.  39
    The impossibility and the necessity of quality of life research.E. Haavi Morreim - 1992 - Bioethics 6 (3):219–232.
  16.  24
    About face: Downplaying the role of the press in facial transplantation research.E. Haavi Morreim - 2004 - American Journal of Bioethics 4 (3):27 – 29.
  17.  10
    The Impossibility and the Necessity of Quality of Life Research.E. Haavi Morreim - 2007 - Bioethics 6 (3):219-232.
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  18.  26
    Quality of Life: Erosions and Opportunities Under Managed Care.E. Haavi Morreim - 2000 - Journal of Law, Medicine and Ethics 28 (2):144-158.
    In recent years a number of commentators have discussed the importance of measuring quality of life in health care. We want to know whether an intervention will help people to live better, not just longer, and whether some treatments cause more trouble than they are worth. New technologies promise wondrous benefits. But when millions of people have no insured access to health care, and when many others face increasingly stringent limits on care, technologies’ high costs require us to choose what (...)
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  19.  19
    Quality of Life: Erosions and Opportunities under Managed Care.E. Haavi Morreim - 2000 - Journal of Law, Medicine and Ethics 28 (2):144-158.
    In recent years a number of commentators have discussed the importance of measuring quality of life in health care. We want to know whether an intervention will help people to live better, not just longer, and whether some treatments cause more trouble than they are worth. New technologies promise wondrous benefits. But when millions of people have no insured access to health care, and when many others face increasingly stringent limits on care, technologies’ high costs require us to choose what (...)
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  20.  20
    ""By any other name: the many iterations of" patient advocate" in clinical research.E. Haavi Morreim - 2004 - IRB: Ethics & Human Research 26 (6):1.
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  21.  24
    Cost Constraints as a Malpractice Defense.E. Haavi Morreim - 1988 - Hastings Center Report 18 (1):5-10.
    Cost‐containment pressures impose fiscal responsibilities upon physicians that can conflict with their fiduciary commitment to patients. Should the law permit health care providers to adjust standards of care according to patients' financial resources? The legal concept of “rebuttable presumption” should be used to reconceive the traditional requirement of a uniform standard of care.
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  22. Cost containment: Issues of moral conflict and justice for physicians.E. Haavi Morreim - 1985 - Theoretical Medicine and Bioethics 6 (3).
    In response to rapidly rising health care costs in the United States, federal and state governments and private industry are instituting numerous and diverse cost-containment plans. As devices for coping with a scarcity of resources, such plans present serious challenges to physicians' traditional single-minded devotion to patient welfare. Those which contain costs by directly limiting medical options or by controlling physicians' daily clinical decisions can threaten the quality of medical care by allowing economic authorities to make essentially medical judgments. In (...)
     
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  23.  38
    Moral Justice and Legal Justice in Managed Care: The Ascent of Contributive Justice.E. Haavi Morreim - 1995 - Journal of Law, Medicine and Ethics 23 (3):247-265.
    Several prominent cases have recently highlighted tension between the interests of individuals and those of the broader population in gaining access to health care resources. The care of Helga Wanglie, an elderly woman whose family insisted on continuing life support long after she had lapsed into a persistent vegetative state, cost approximately $750,000, the majority of which was paid by a Medi-gap policy purchased from a health maintenance organization. Similarly, Baby K was an anencephalic infant whose mother, believing that all (...)
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  24.  14
    Moral Justice and Legal Justice in Managed Care: The Ascent of Contributive Justice.E. Haavi Morreim - 1995 - Journal of Law, Medicine and Ethics 23 (3):247-265.
    Several prominent cases have recently highlighted tension between the interests of individuals and those of the broader population in gaining access to health care resources. The care of Helga Wanglie, an elderly woman whose family insisted on continuing life support long after she had lapsed into a persistent vegetative state, cost approximately $750,000, the majority of which was paid by a Medi-gap policy purchased from a health maintenance organization. Similarly, Baby K was an anencephalic infant whose mother, believing that all (...)
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  25.  59
    Innovation in Human Research Protection: The AbioCor Artificial Heart Trial.E. Haavi Morreim, George E. Webb, Harvey L. Gordon, Baruch Brody, David Casarett, Ken Rosenfeld, James Sabin, John D. Lantos, Barry Morenz, Robert Krouse & Stan Goodman - 2006 - American Journal of Bioethics 6 (5):W6-W16.
    Human clinical research has become a huge economic enterprise (Morin et al. 2002; Noah 2002). Because the human subject at the center can be so easily marginalized, many commentators recommend spec...
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  26. Bioethics and the Press.E. Haavi Morreim - 1999 - Journal of Medicine and Philosophy 24 (2):101-107.
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  27.  20
    Lifestyles of the Risky and Infamous: From Managed Care to Managed Lives.E. Haavi Morreim - 1995 - Hastings Center Report 25 (6):5-12.
    As managed care organizations provide an increasing proportion of citizens' health care, the move toward asking individuals to help control costs by taking more responsibility for their health is likely to intensify. Economic, medical, and legal responses to lifestyle‐induced health care costs raise concerns as well as possibilities for using resources responsibly.
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  28. Philosophy lessons from the clinical setting: Seven sayings that used to annoy me.E. Haavi Morreim - 1986 - Theoretical Medicine and Bioethics 7 (1).
    Traditional medical approaches to moral issues found in the clinical setting can, if properly understood, enlighten our philosophical understanding of moral issues. Moral problem-solving, as distinct from ethical and metaethical theorizing, requires that one reckon with practical complexities and uncertainties. In this setting the quality of one's answer depends not so much upon its content as upon the quality of reasoning which supports it. As the discipline which especially focuses upon the attributes of good-quality reasoning, philosophy therefore has much to (...)
     
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  29.  27
    Result-Based Compensation in Health Care: A Good, But Limited, Idea.E. Haavi Morreim - 2001 - Journal of Law, Medicine and Ethics 29 (2):174-181.
    David Hyman and Charles Silver are quite right. Opinion 6.01 in the American Medical Association's Code of Medical Ethics is difficult to defend. Ties between compensation and outcomes need not mislead patients into thinking that results are guaranteed; they are widely used in other fields with considerable success, even if they have some disadvantages; they can potentially bring patients more actively into decision-making about whether and from whom to purchase which medical care; and, if carefully tuned, they can promote quality (...)
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  30.  15
    Patient-funded research: paying the piper or protecting the patient?E. Haavi Morreim - 1990 - IRB: Ethics & Human Research 13 (3):1-6.
  31.  14
    Result-Based Compensation in Health Care: A Good, but Limited, Idea.E. Haavi Morreim - 2001 - Journal of Law, Medicine and Ethics 29 (2):174-181.
    David Hyman and Charles Silver are quite right. Opinion 6.01 in the American Medical Association's Code of Medical Ethics is difficult to defend. Ties between compensation and outcomes need not mislead patients into thinking that results are guaranteed; they are widely used in other fields with considerable success, even if they have some disadvantages; they can potentially bring patients more actively into decision-making about whether and from whom to purchase which medical care; and, if carefully tuned, they can promote quality (...)
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  32.  10
    Alternative Health Care: Limits of Science and Boundaries of Access.E. Haavi Morreim - 2002 - In Rosamond Rhodes, Margaret P. Battin & Anita Silvers (eds.), Medicine and Social Justice:Essays on the Distribution of Health Care: Essays on the Distribution of Health Care. Oup Usa. pp. 319.
  33.  4
    Am I My Brother's Warden? Responding to the Unethical or Incompetent Colleague.E. Haavi Morreim - 1993 - Hastings Center Report 23 (3):19-27.
    Responding to the failings of peers can be difficult, but as professionals physicians should not leave the moral management of errant colleagues to chance. Distinguishing levels of adverse outcomes helps physicians more clearly assess each others' conduct and respond appropriately to those who threaten the integrity of the profession.
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  34.  7
    Am I rotheris Warden?E. Haavi Morreim - forthcoming - Hastings Center Report.
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  35.  19
    Another kind of end-run: Status upgrades.E. Haavi Morreim - 2005 - American Journal of Bioethics 5 (4):11 – 12.
  36.  8
    Assessing Quality of Care: New Twists from Managed Care.E. Haavi Morreim - 1999 - Journal of Clinical Ethics 10 (2):88-99.
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  37. Access without excess.E. Haavi Morreim - 1992 - Journal of Medicine and Philosophy 17 (1):1-6.
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  38.  34
    Beyond the Lies: Solving the Problem.E. Haavi Morreim - 2004 - American Journal of Bioethics 4 (4):61-63.
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  39.  4
    Am I My Brother's Warden?: Responding to the Unethical or Incompetent Colleague.E. Haavi Morreim - 2012 - Hastings Center Report 23 (3):19-27.
    Responding to the failings of peers can be difficult, but as professionals physicians should not leave the moral management of errant colleagues to chance. Distinguishing levels of adverse outcomes helps physicians more clearly assess each others' conduct and respond appropriately to those who threaten the integrity of the profession.
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  40.  32
    Conception and the concept of harm.E. Haavi Morreim - 1983 - Journal of Medicine and Philosophy 8 (2):137-158.
    In recent years, science and the courts have created new options whereby prospective parents can avoid the birth of a diseased or defective child. We can ascertain the likelihood that certain genetic diseases will be transmitted; We can detect a number of fetal abnormalities in utero ; we have legal permission to abort for any reason, including fetal abnormality. With these new options come new questions concerning our moral obligations toward our prospective offspring. An important conceptual question concerns whether such (...)
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  41.  24
    Civil Disobedience: The Devil Is in the Details.E. Haavi Morreim - 2005 - Hastings Center Report 35 (4):4.
  42.  9
    Clinicians or Committees: Who Should Cut Costs?E. Haavi Morreim - 1987 - Hastings Center Report 17 (2):45-45.
  43.  8
    Impairments and Impediments in Patients’ Decision Making: Reframing the Competence Question.E. Haavi Morreim - 1993 - Journal of Clinical Ethics 4 (4):294-307.
  44.  27
    Physician investment and self-referral: Philosophical analysis of a contentious debate.E. Haavi Morreim - 1990 - Journal of Medicine and Philosophy 15 (4):425-448.
    A new economic phenomenon, in which physicians refer their patients to ancillary facilities of which they themselves are owners or substantial investors, presents a ‘laboratory’ for assessing philosophers' potential contributions to public policy issues. In this particular controversy, ‘prohibitionists’ who wish to ban all such self-referral focus on the dangers that patients and payers may receive or be billed for unnecessary or poor-quality care. ‘Laissez-fairists’, in contrast, argue that self-referral should be freely permitted, with a reliance on personal ethics and (...)
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  45.  11
    Result-Based Compensation in Health Care: A Good, But Limited, Idea.E. Haavi Morreim - 2001 - Journal of Law, Medicine and Ethics 29 (1):174-181.
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  46.  16
    Stratified Scarcity: Redefining the Standard of Care.E. Haavi Morreim - 1989 - Journal of Law, Medicine and Ethics 17 (4):356-367.
    Professor Hall is to be congratulated on his thoughtful analysis of an issue that, as he rightly suggests, “is one of the most important issues that will confront health care tort law throughout the remainder of the century.”’ He argues that malpractice law currently can accommodate considerable latitude both for a conservative streamlining of medical practices in general and for a cost-sensitivity in individual treatment decisions. And he further argues that existing tort principles, such as the locality rule, can comfortably (...)
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  47.  16
    Stratified Scarcity: Redefining the Standard of Care.E. Haavi Morreim - 1989 - Journal of Law, Medicine and Ethics 17 (4):356-367.
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  48.  13
    The MD and the DRG.E. Haavi Morreim - 1985 - Hastings Center Report 15 (3):30-38.
    As they struggle to maintain high‐quality health care in the face of new economic limitations, physicians should not endanger their relationships with patients. But they should collectively revise the informal protocols that guide clinical decision making.
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  49.  28
    The new economics of medicine: Special challenges for psychiatry.E. Haavi Morreim - 1990 - Journal of Medicine and Philosophy 15 (1):97-119.
    The ongoing economic overhaul of medicine creates two basic imperatives – boosting profits and containing costs – that pose special ethical and philosophical challenges for psychiatry. Because insurance coverage still favors inpatient care, pressures to raise renevues translate into a corresponding pressure on psychiatry as a whole to expand its diagnostic categories, and on individual psychiatrists to ascribe these diagnoses liberally and to hospitalize as many patients as possible. Reciprocally, cost containment requires all physicians to justify their care as clearly (...)
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  50. Ties without tethers : bioethics corporate relations in the AbioCor artificial heart trial.E. Haavi Morreim - 2007 - In Lisa A. Eckenwiler & Felicia Cohn (eds.), The ethics of bioethics: mapping the moral landscape. Baltimore: Johns Hopkins University Press.
     
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