Conscience and conscientious actions in the context of MCOs

Kennedy Inst Ethics J. 1997 Dec;7(4):403-11. doi: 10.1353/ken.1997.0029.


Managed care organizations can produce conflicts of obligation and conflicts of interest that may lead to problems of conscience for health care professionals. This paper provides a basis for understanding the notions of conscience and conscientious objection and offers a framework for clinicians to stake out positions grounded in personal conscience as a way for them to respond to unacceptable pressures from managers to limit services.

MeSH terms

  • Complicity
  • Conflict of Interest*
  • Conscience*
  • Contracts
  • Deception
  • Delivery of Health Care
  • Disclosure
  • Dissent and Disputes
  • Employment
  • Fees and Charges
  • Gatekeeping
  • Government Regulation
  • Group Processes
  • Health Care Rationing
  • Health Maintenance Organizations
  • Humans
  • Jurisprudence
  • Managed Care Programs*
  • Moral Obligations*
  • Morals
  • Motivation*
  • Patients
  • Physicians*
  • Politics
  • Public Policy
  • Referral and Consultation
  • Resource Allocation
  • Social Control, Formal
  • Social Responsibility*
  • Truth Disclosure
  • Utilization Review
  • Whistleblowing
  • Withholding Treatment