Ethics and mental health service delivery under managed care

Ethical Issues with Managed Care

With the advent of managed care, counseling psychologists are encountering vexing ethical issues. These issues arise not only for practitioners but for researchers, educators, and trainers as well. In this article, the authors briefly describe the evolution of managed care and review basic biomedical ethics and ethical decision-making models. The authors then examine specific ethical issues and offer suggestions for practice, research, and education and training. This article concludes with a research agenda, a review of projected general trends in health care delivery, and a discussion of counseling psychology’s role in addressing current concerns as well as influencing the future evolution of health care delivery.

When there are limits on health care resources

Controlling health care costs has been a goal within the health care system for nearly 40 years. Yet, what is occurring is that health care costs are actually increasing, and the quality of care is decreasing. Patients and health professionals are complaining that accessibility to services is limited. There are inadequate numbers of nursing staff to care for patients who are both sicker and have shorter lengths of stay. Patients are bewildered by a system that they find to be extremely impersonal and difficult to navigate. This article uses a hypothetical case to identify and examine some of the ethical issues related to access to health care within a managed care system. Recommendations for nurses are presented to help them meet the challenges of limited health care resources.