Ethical Challenges in Managed Care

A Casebook

Karen G. Gervais, Reinhard Priester, Dorothy E. Vawter, Kimberly K. Otte, and Mary M. Solberg, Editors

"A timely and welcome attempt to identify important, if not uncommon, predicaments in managed care."
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The rapid rise of managed care in the United States has introduced new complexities into ethical dilemmas in health care by changing the traditional relationships among health plans, payers, providers, and patients. Through twenty case studies that provide snapshots of a wide range of ethical challenges, this book explores the goals, methods, and practices of managed care.

Accompanying each case are questions for consideration and a pair of commentaries by prominent contributors from diverse fields. Through the cases and commentaries, this book clarifies the internal workings of managed care, explains relevant concepts, and offers practical, constructive guidance in addressing the ethical and policy issues.

The cases address a broad spectrum of issues concerning rationing shared resources, financial incentives, quality of care, and responsibilities to patients, vulnerable populations, and the community. Specific topics range from coverage of emergency services through funding medical education to respecting patients' religious beliefs and caring for the seriously mentally ill.

This casebook offers a wealth of insights into critical issues that affect the delivery of managed care in an increasingly competitive market. It will be invaluable for those managing the delivery and financing of health care and for students and practitioners of the health professions and health administration, as well as interested recipients of managed care.

Table of Contents


"A timely and welcome attempt to identify important, if not uncommon, predicaments in managed care."—Bioethics Forum

"One of the most interesting areas of the current managed care debate is one that receives far too little attention: that is the ethical dimension. This book has gone a long way to fill this gap, especially when it comes to help clarify lines of responsibility and accountability. This is an important and powerful book."—U.S. Senator Paul Wellstone


Mila Ann Aroskar Howard Brody Donald J. Brunnquell Roger J. Bulger Arthur L. Caplan Kate T. Christensen Larry R. Churchill Ronald E. Cranford Kathleen A. Culhane-Pera Raymond G. DeVries Joanne M. Disch Daniel O. Dugan Mary L. Durham Linda L. Emanuel Michael Felder Leonard M. Fleck Joel E. Frader Karen G. Gervais Bradford H. Gray Martin Gunderson Gwen Wagstrom Halaas Mark A. Hall Gayle Hallin David A. Hyman Karen A. Jordan Rosalie A. Kane William T. McGivney David Mechanic Ruth A. Mickelsen E. Haavi Morreim James Lindemann Nelson Genevieve Noone Parsons Gail J. Povar Lee J. Raiola Susan B. Rubin James E. Sabin Judith Shindul-Rothschild Mitchell Sugarman Peter A. Ubel Robert M. Veatch Susan M. Wolf Matthew K. Wynia Laurie Zoloth

Supplemental Materials


About the Author

Karen G. Gervais is director of the Minnesota Center for Health Care Ethics in Minneapolis, Minnesota.

Reinhard Priester is a health policy consultant and associate for health policy at the Minnesota Center for Health Care Ethics.

Dorothy E. Vawter is associate director of the Minnesota Center for Health Care Ethics.

Kimberly K. Otte is an attorney in the Legal and Public Affairs Departments of Allina Health System in Minneapolis.

Mary M. Solberg is an assistant professor of religion at Gustavus Adolphus College, St. Peter, Minnesota, and a center associate at the Minnesota Center for Health Care Ethics.

384 pp., 6 x 9

Jan 1999

384 pp., 6 x 9

ISBN: 978-0-87840-719-4
Jan 1999

384 pp.

ISBN: 978-1-58901-809-9
Jan 1999

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