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A further complication in my mind of healthcare operating as a market is a hippocratic oath. The ability for a doctor (merchant) to refuse service in certain s

A further complication in my mind of healthcare operating as a market is a hippocratic oath. The ability for a doctor (merchant) to refuse service in certain situations just doesn't exist without violating an ethical boundary.

deleted 9y ago
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humanrebar 9y ago
I don't follow. A ornery mechanic can refuse business all she wants. And doctors often refuse to perform procedures they don't want to perform for financial or professional reasons.
PeterisP 9y ago
Hippocratic oath generally does not prevent arbitrary reasons (including payment) for refusing to take on a patient in most versions (I'm aware that some places, including some medical teaching institutions have it vice versa) including the earliest surviving original one. Hippocrates and his students would not treat everyone or require the students to treat everyone, the oath describes the ethical boundaries of the 'implied contract' between a doctor and their patient - and becoming a doctor's patient even back then was conditional on doctor choosing to treat you, most likely (but not necessarily) based on your agreement. Neither classic Hippocratic oath nor the commonly used Declaration of Geneva (https://en.wikipedia.org/wiki/Declaration_of_Geneva https://en.wikipedia.org/wiki/Declaration_of_Geneva) would go against a doctor saying "the recommended procedure to cure your ailment costs one million dollars; I'll be treating you if and only if you pay that", assuming that the treatment honestly is the best option health-wise. What the oath could prohibit is the recommendation of a treatment that's objectively worse (i.e. less effective, or more likely to have harmful or fatal complications) but is much cheaper; while a person can choose (or be recommended) bread, wine or car that's worse but cheap, the ethics frown upon recommending worse health outcomes.
- tkahnoski 9y ago
  Thank you for the links, these were just vague concepts to me before where I understood the intent, but I shall read up on the specifics now. In planned events and traditional health care your argument makes sense. I was specifically thinking about emergency care or other situations where communication isn't always possible or made in a timely manner. If a someone comes into an ER and turns out needs say a stent put in, when do you get clear agreement? (caveat I am clearly not a medical professional and this might be a terrible example). My assumption is largely the hospital does not wait to validate someone's credit to execute what would otherwise be something done for normal retail transactions of similar size.

deleted 9y ago

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humanrebar 9y ago

I don't follow. A ornery mechanic can refuse business all she wants. And doctors often refuse to perform procedures they don't want to perform for financial or professional reasons.

PeterisP 9y ago

Hippocratic oath generally does not prevent arbitrary reasons (including payment) for refusing to take on a patient in most versions (I'm aware that some places, including some medical teaching institutions have it vice versa) including the earliest surviving original one. Hippocrates and his students would not treat everyone or require the students to treat everyone, the oath describes the ethical boundaries of the 'implied contract' between a doctor and their patient - and becoming a doctor's patient even back then was conditional on doctor choosing to treat you, most likely (but not necessarily) based on your agreement. Neither classic Hippocratic oath nor the commonly used Declaration of Geneva (https://en.wikipedia.org/wiki/Declaration_of_Geneva https://en.wikipedia.org/wiki/Declaration_of_Geneva) would go against a doctor saying "the recommended procedure to cure your ailment costs one million dollars; I'll be treating you if and only if you pay that", assuming that the treatment honestly is the best option health-wise. What the oath could prohibit is the recommendation of a treatment that's objectively worse (i.e. less effective, or more likely to have harmful or fatal complications) but is much cheaper; while a person can choose (or be recommended) bread, wine or car that's worse but cheap, the ethics frown upon recommending worse health outcomes.

tkahnoski 9y ago
Thank you for the links, these were just vague concepts to me before where I understood the intent, but I shall read up on the specifics now. In planned events and traditional health care your argument makes sense. I was specifically thinking about emergency care or other situations where communication isn't always possible or made in a timely manner. If a someone comes into an ER and turns out needs say a stent put in, when do you get clear agreement? (caveat I am clearly not a medical professional and this might be a terrible example). My assumption is largely the hospital does not wait to validate someone's credit to execute what would otherwise be something done for normal retail transactions of similar size.