Marketisation, Ethics and Healthcare

How does the market affect and redefine healthcare? The marketisation of Western healthcare systems has now proceeded well into its fourth decade. But the nature and meaning of the phenomenon has become increasingly opaque amidst changing discourses, policies and institutional structures. Moreover, ethics has become focussed on dealing with individual, clinical decisions and neglectful of the political economy which shapes healthcare. This interdisciplinary volume approaches marketisation by exploring the debates underlying the contemporary situation and by introducing reconstructive and reparative discourses. The first part explores contrary interpretations of 'marketisation' on a systemic level, with a view to organisational-ethical formation and the role of healthcare ethics. The second part presents the marketisation of healthcare at the level of policy-making, discusses the ethical ramifications of specific marketisation measures and considers the possibility of reconciling market forces with a covenantal understanding of healthcare. The final part examines healthcare workers' and ethicists' personal moral standing in a marketised healthcare system, with a view to preserving and enriching virtue, empathy and compassion. Chapters 4 and 7 of this book are freely available as downloadable Open Access PDFs at http://www.taylorfrancis.com under a Creative Commons Attribution-Non Commercial-No Derivatives (CC-BY-NC-ND) 4.0 license.

Therese Feiler is the postdoctoral researcher with the Healthcare Values Partnership in the Faculty of Theology and Religion and Research Fellow at Harris Manchester College, University of Oxford, UK Joshua Hordern leads the Oxford Healthcare Values Partnership and is Associate Professor of Christian Ethics in the Faculty of Theology and Religion and a Fellow of Harris Manchester College, University of Oxford, UK. Andrew Papanikitas is NIHR Academic Clinical Lecturer in General Practice at the Department of Primary Care Health Sciences and Research Fellow at Harris Manchester College, University of Oxford, UK.

Part I. The Place of the Market 1. Why the Economic Calculation Debate Matters: The Case for Decentralisation in Healthcare Pythagoras Petratos 2. The Abuse of 'Ethic' in Capitalist Medicine Miran Epstein 3. Organisational Ethics: A Solution to the Challenges of Markets in Healthcare? Lucy Frith Part II. The Influence of the Market 4. Encoding Truths? Diagnosis-Related Groups and the Fragility of the Marketisation Discourse Therese Feiler 5. Personal Budgets: Holding onto the Purse Strings for Fear of Something Worse Jonathan Herring 6. "More than my job is worth" - Defensive Medicine and the Marketisation of Healthcare Anant Jani and Andrew Papanikitas 7. Covenant, Compassion, and Marketisation in Healthcare: The Mastery of Mammon and the Service of Grace Joshua Hordern Part III. The Place of Ethics 8. Commercialisation and the Corrosion of the Ideals of Medical Professionals Adrian Walsh 9. The Virtuous Professional and the Marketplace David Misselbrook 10. Empathy in Healthcare: The Limits and Scope of Empathy in Public and Private Systems Angeliki Kerasidou and Ruth Horn 11. Accounting for Ethics: Is there a Market for Morals in Healthcare? Andrew Papanikitas What next? - Editors' epilogue Therese Feiler, Joshua Hordern, Andrew Papanikitas