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Biomedical subjects

Patricia H Werhane

Publications and source records attributed to Patricia H Werhane.

8 recordsLinked to original sources
PubMed2006

Access, responsibility, and funding: A systems thinking approach to universal access to oral health.

Universal access to oral health care is a justifiable demand for a number of disparate but morally sound reasons. Nevertheless, that conclusion, however reached, has not solved the problem of the lack of access. Market forces, scarcity of funding, and lack of clarity as to who is responsible for ensuring that oral care is available seem to present insurmountable difficulties. I shall argue that these are not irresolvable problems, but the resolution has to take place through the tool of systems thinking and a systemic approach to moral imagination. Taking the lead from Susan Wolf's and Linda Emanuel's work on systems thinking, and developing ideas from work on mental models and moral imagination, I shall argue that what is often missing in discussions and demands for universal access to oral health care is a morally imaginative systemic approach that takes into account the multi-perspective dynamics involved in health care today. Moral imagination may encourage sound, broad-based, more inclusive moral thinking and moral judgment without ignoring the critical roles and responsibilities each of us has as professionals, providers, payers, or patients, without which change will not take place at all.

Dental Care↗
PubMed2005

Intellectual property rights, moral imagination, and access to life-enhancing drugs.

Although the idea of intellectual property (IP) rights--proprietary rights to what one invents, writes, paints, composes or creates--is firmly embedded in Western thinking, these rights are now being challenged across the globe in a number of areas. This paper will focus on one of those challenges: government-sanctioned copying of patented drugs without permission or license of the patent owner in the name of national security, in health emergencies, or life-threatening epidemics. After discussing standard rights-based and utilitarian arguments defending intellectual property we will present another model. IP is almost always a result of a long history of of scientific or technological development and numbers of networks of creativity, not the act of a single person or a group of people at one moment in time. Thus thinking about and evaluating IP requires a traditional model of IP. It follows that the owner of those rights has some obligations to share that information or its outcomes. If that conclusion is applied to the distribution of antiretroviral drugs, what pharmaceutical companies are ethically required to do to increase access to these medicines in the developing world will have to be reanalyzed from a more systemic perspective.

Anti-HIV Agents↗
PubMed2004

The Rashomon effect: organization ethics in health care.

The Academy-Award winning 1950 Japanese movie Rashomon depicts an incident involving an outlaw, a rape or seduction of a woman, and a murder or suicide of her husband. A passer-by, who is also the narrator, explains how the story is told to officials from four different perspectives: that of the outlaw, the woman, the husband and himself. The four narratives agree that the outlaw, wandering through the forest, came upon the woman on a horse being led by her husband; the outlaw tied up the husband, sex took place between the woman and the outlaw in front of the bound husband, and the husband was found dead. The narratives do not agree on how these events occurred or who killed the husband. The outlaw contends that consensual sex occurred between him and the wife, and he claims to have killed the husband. The wife depicts the sex as rape and claims that because of her disgrace she killed her husband. The husband, through a medium, says that the sexual act began as rape and ended in consent, and that in shame, after being untied by the outlaw he killed himself. The passer-by's story agrees with the husband's account of the sex and the bandit's account of the murder. Because the passer-by is also the narrator of the film, we tend to believe his version. But what actually took place is never resolved.

Ethics Committees, Clinical↗
PubMed2003

Stakeholder expectations in practice-based medicine.

Competitive pressures are forcing physicians from solo practice into new organizational structures. These new structures and the technologies supporting them have generated suggestions for improving medical practice. This article examines the unspoken assumption often accompanying these suggestions that practice improvement can come about through a closer alignment of the practice's goals and values with its stakeholders' expectations. Because conflict among competing goals is inevitable in a resource-scarce environment, an important question for each practice, and for each individual physician in a practice, is how to adjudicate conflicts of value when the goals of the practice appear to collide. This essay concludes with a proposal for an adjudicating process to help resolve these conflicts in practice-based medicine.

Education, Medical, Continuing↗