Addressing Dual Agency: Getting Specific About the Expectations of Professionalism

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Professionalism requires that physicians uphold the best interests of patients while simultaneously insuring just use of health care resources. Current articulations of these obligations like the American Board of Internal Medicine (ABIM) Foundation's Physician Charter do not reconcile how these obligations fit together when they conflict. This is the problem of dual agency. The most common ways of dealing with dual agency: "bunkering"-physicians act as though societal cost issues are not their problem; "bailing"-physicians assume that they are merely agents of society and deliver care typically based on a strongly consequentialist public health ethic; or "balancing"-a vaguely specified attempt to uphold both patient welfare and societal need for judicious resource use simultaneously-all fail. Here I propose how the problem of dual agency might begin to be addressed with rigor and consistency. Without dealing with the dual agency problem and getting more specific about how to reconcile its norms when they conflict, the expectations of professionalism risk being written off as cute, nonbinding aphorisms from the medical profession.

Original languageEnglish (US)
Pages (from-to)29-36
Number of pages8
JournalAmerican Journal of Bioethics
Volume14
Issue number9
DOIs
StatePublished - 2014

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Physicians
Health Resources
Internal Medicine
Ethics
Public Health
Delivery of Health Care
Costs and Cost Analysis
Professionalism
bailing

Keywords

  • dual agency
  • health care
  • physicians
  • professional ethics
  • professionalism
  • role morality

ASJC Scopus subject areas

  • Health Policy
  • Issues, ethics and legal aspects

Cite this

Addressing Dual Agency : Getting Specific About the Expectations of Professionalism. / Tilburt, Jon C.

In: American Journal of Bioethics, Vol. 14, No. 9, 2014, p. 29-36.

Research output: Contribution to journalArticle

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