Michael Welker | Eva Winkler | John Witte, Jr. | Stephen Pickard (Eds.): The Impact of Health Care (Leseprobe)

Introduction
Eva C. Winkler and Michael Welker
This volume focuses on the role of health care and medicine in their impact on
character formation, ethical education, and the communication ofvalues in late
modern pluralistic societies. The contributions are arranged in four sections. The
first deals with the tensions that medical ethics faces between the demands of
medical ethos and the challenges of the economization of health care. The second
part addresses ethical impacts of advancing medical research and techniques.
The third part looks at some ethical aspects of the digital transformation
in medicine and health care. The fourth part is concerned with developments in
ethos and education in health care and medicine, with different perspectives on
human destiny in medical anthropology and theology, and with aview of psychotherapy
on the topics of the volume.
Part One addresses the ethical tensions in the health-care system between
professional responsibilities toward the individual patient and realizing those
responsibilities in acomplex health-care system with limited resources.
Eva C. Winkler sets out to define the role of professional ethics for the individual
doctor as well as deriveddesiderata for organizational ethics in the face of
economization of the health-care system in Germany, where financial pressure
has increased in recent years. She reports the empirical data indicating that the
so-called economization has significant impact on medical decision-making and
action and consequently potentially also on the doctor–patient relationship.
While economic considerations are necessary and in part desired—for example,
when the same goal can be achieved by less expensive means—other economic
incentives can compromise the quality of treatment and trust in the entire medical
profession.
She starts with the physician’sperspective on economic incentives reflected
in empirical data and then analyzes three different responses to cost pressure
from anormative perspective withconsiderations about the appropriateforms of
economization in the medical system: enhancing efficiency, increasing revenue,
and rationing or forgoing effective medical interventions to save money. She
then evaluates the types of ethical guidance available to physicians to resolve