[Woodstock Report, June 1999, No. 58] We have sold over 1,300 copies thus far to managed health care organizations,
hospitals, medical schools and other academic health care centers and national health care
organizations from 46 states. To order a copy of Ethical Issues in Managed Care Organizations, a 42-page guide
to ethical decision making for managers and executives of managed health care
organizations, please make check payable to: Woodstock Theological Center,
Georgetown University, Box 571137, Washington, DC 20057-1137; tel. 202-687-3532; fax
202-687-5835; Individual copies, $8.00 a copy; bulk orders (20 or more) $6.00 a copy. Postage and
handling: $2.00 per copy; $10.00 for 20 or more. Ethical Issues in Managed Health Care Organizations (Georgetown University
Press, 1999) is the product of four conferences and a two-year discussion by members of
the health care community, managed health care executives and administrators, ethicisits,
and business executives. See press release. Copies may be ordered from the Woodstock Theological Center. [Woodstock Report, December 1998, No. 56] This project is funded by The Robert Wood Johnson Foundation. The Woodstock Center
remains grateful to the foundation for its support and to the seminar participants who
have generously given of their expertise and time. [Woodstock Report, June 1998, No. 54] The fourth and final meeting of participants in Woodstock’s business ethics
seminar, Ethical Issues in Managed Health Care Organizations, was held on April 20.
Participants include senior executives and medical directors of managed health care
organizations, physicians, nurses, administrators of hospitals and clinics, purchasers of
health plans (employers), ethicists, and academics. The major item on the agenda was a
discussion of the first draft of a consensus statement intended to assist managed care
executives, administrators, medical directors, and others in ethical decision making. The
consensus statement identifies the particular ethical issues faced by managed care
executives and administrators, outlines the core values that should form the basis for
ethical decision making, and suggests a process that will be useful in ethical decision
making. Seminar participants broke into small groups, each using the same case study, to test
the practicality of the suggested decision-making process and to rank the core values
suggested in the draft document. A lively discussion followed on steps that are necessary
for making ethical decisions in the managed health care environment; participants then
ranked the core values that should be addressed in the decision-making process. A revised
draft of the consensus statement will be prepared under the direction of the seminar
steering committee and sent to participants for their final approval before being
published as a monograph early in 1999. This project is funded by The Robert Wood Johnson Foundation. The Woodstock Center
remains grateful to the foundation for its support and to the seminar participants who
have generously given of their expertise and time. [Woodstock Report, October 1997, No. 51] The fourth in a series of Woodstock Business Ethics Seminars
held its second meeting of seminar participants on Thursday, October 30, 1997. The focus
of this second meeting was to reach a shared understanding of the location and
reasons for ethical conflicts in the large and complicated "network" which is
the managed care system. In reaching this understanding, the seminar participants focused
on decisions and decision making as the key to tracing these ethical quandaries. The goal of this seminar is to develop a consensus statement that will be useful to
managed care executives, medical personnel, and employers in making ethical decisions when
conflicts arise between the goals of containing costs and providing quality health care.
The seminar participants, in developing the consensus statement, will: 1) identify the
particular ethical issues faced by executives and managers of managed care organizations;
2) outline the core values that should form the basis for ethical decision making by
executives and managers of managed care organizations and by those responsible for the
design and purchase of managed care plans; 3) reach consensus on the ethical course of
action in particular cases; and 4) develop a checklist of questions which health care
providers can use to minimize the potential for conflicts of interest in decision making
and to help them fully assess the ethical significance of the decisions they make. [Woodstock Report, June 1997, No. 50] The first meeting of the Woodstock business ethics seminar, "Ethical
Issues in Managed Health Care Systems," was held on May 30, 1997.
The aim of this meeting was: (1) to identify major cases or issues in
the business aspects of managed health aim of this meeting was: care;
(2) thereby to discover the recognize the different perspectives from
which various scope of this project; and (3) to participants see particular
issues. The forty participants included private and health maintenance organization physicians,
administrators of medical schools and hospitals, nurses, senior executives of managed care
and national health care organizations, purchasers of health insurance plans, ethicists,
and academics. The discussion focused on ethical issues faced by administrators of managed
health care systems, purchasers of managed health care plans, physicians (private practice
and managed care), nurses, and hospital administrators. See highlights
of the ethical issues discussed by the participants. The second meeting will be held in October 1997 to
analyze the cases described at the first meeting in order to identify the root cause(s) of
ethical conflict. This study is funded by The
Robert Wood Johnson Foundation. Press Release WASHINGTON, D.C. - The Woodstock Theological Center at
Georgetown University announced today that The Robert Wood Johnson Foundation has approved
a grant of $269,894 to the Woodstock Center for support of a two-year study entitled
"Ethical Issues in Managed Health Care Systems." According to Jesuit Father James L. Connor, director of the Woodstock Center, "The
Woodstock Theological Center is grateful to The Robert Wood Johnson Foundation for giving
us the opportunity to explore important ethical issues in managed health care systems
during a period in the nation's history when questions about the business ethics of
managed health care are foremost in the minds of health care professionals and the people
whom they serve." This project, the fourth in a series of Woodstock business ethics
seminars, will examine the ethical issues faced by executives and managers of managed
care organizations. In particular, seminar participants will review the dilemmas that
arise from conflicts between the goals of containing costs and providing quality health
care, outline the core values that should form the basis for ethical decision making by
executives and managers of managed care organizations and by those responsible for the
design and purchase of managed care plans, and recommend ethical responses for concrete
cases. Finally, seminar participants will develop a checklist of questions which managed
care officials can use to minimize the potential for conflicts of interest in decision
making and to help them fully assess the ethical significance of the decisions they make. The Woodstock Center will bring together nationally recognized executives and managers
of the various types of managed care systems with purchasers of managed care and
representatives of other constituencies-those who work on the "front lines" of
managed care, suppliers of goods and services to the managed care industry, consumers of
managed care, and academic experts. Their consensus statement for health care providers
will be published and distributed throughout the managed care industry. Steering committee members for the managed health care project are: Margaret M. Blair,
senior fellow, Economics Studies Program, the Brookings
Institution; William J. Byron, S.J., director, Center for the Advanced Study of
Ethics, Georgetown University and distinguished professor, Business School, Georgetown
University; James L. Connor, S.J., director, the Woodstock
Theological Center; John P. Langan, S.J., Rose Kennedy Professor of Ethics, Kennedy Institute of Ethics, and
Georgetown University; General Edward C. Meyer (Ret.); Ambassador Henry Owen, Salomon
Brothers; Edmund D. Pellegrino, M.D., John Carroll Professor of Medicine and Medical
Ethics, Center for Clinical Bioethics, Georgetown
University Medical Center; Charles O. Rossotti, chairman, American Management Systems,
Inc.; Kevin A. Schulman, M.D., director, Clinical Economics Research Unit, Georgetown University Medical Center;
Patrick J. Scollard, president and chief executive officer, St. Francis Hospital, Roslyn,
N.Y.; and J. Michael Stebbins, senior fellow, Woodstock Theological Center. Steering committee member Dr. Edmund D. Pellegrino points out that, "Since its
inception, managed care has generated a host of difficult ethical issues centering on
conflicts between the goals of cost containment and patient care. Too often these
conflicts are discussed by managers, investors, patients, providers, etc., in isolation
from each other. This Robert Wood Johnson grant affords an extraordinary opportunity for
all the key participants to examine these ethical issues together. Such a collaborative
effort offers the real possibility to clarify the issues, to define the elements of
ethical decision making, and to minimize the potential for conflicts." Previous Woodstock business ethics seminar publications are Ethical
Considerations in the Business Aspects of Health Care (1995), Creating
and Maintaining an Ethical Corporate Climate (1990), and Ethical
Considerations in Corporate Takeovers (1990). More than 20,000 copies of these
publications have been sold or distributed. The Robert Wood Johnson Foundation made two
grants to the Woodstock Center for the support of Ethical Considerations in the Business
Aspects of Health Care. The Woodstock Theological Center, located on the Georgetown
University campus, is a research institute sponsored by the Society of Jesus to
address topics of social, economic, and political importance from a theological and
ethical perspective. The Robert Wood Johnson Foundation, based in Princeton, N.J., is the nation's largest
philanthropy devoted exclusively to health and health care. It became a national
institution in 1972 with receipt of a bequest from the industrialist whose name it bears,
and has since made more than $2 billion in grants. The Foundation concentrates its
grantmaking in three goal areas: to assure that all Americans have access to basic health
care at reasonable cost; to improve the way services are organized and provided to people
with chronic health conditions; and to reduce the personal, social, and economic harm
caused by substance abuse-tobacco, alcohol, and illicit drugs.
June 1999
Ethical Issues in Managed Health Care Organizations
e-mail: woodstock@georgetown.edu
January 1999
Woodstock Issues New Publication on Ethical Issues in Managed Health Care
Organizations
December 1998
Ethical Issues in Managed Health Care Organizations
June 1998
Ethical Issues in Managed Health Care Organizations
October 1997
Ethical Issues in Managed Health Care Organizations
June 1997
Ethical Issues in Managed Health Care Organizations
February 6, 1997
Woodstock Theological Center Receives Robert Wood Johnson Grant to Study Ethical Issues in
Managed Health Care SystemsSee also: