Ethics

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Wisconsin Protests and Physician Integrity

March 4, 2011 in Supply of Medical Services | No comments

Doctors have been giving out sick notes for teachers protesting Wisconsin’s threat to disband their union.  Not only is this wrong, but Dr. Rich of Covert Rationing argues that it isn’t even a form of civil disobedience.  Physicians are often put on a pedestal as the models of professional integrity.  Previous studies, however, have found that doctors are not always so honest.  More from Dr. Rich:

“In a survey…published in the April 12, 2000, issue of the Journal of the American Medical Association, 39% of American doctors admitted that they sometimes or very often manipulated reports to their patients’ health plans so their patients might gain coverage for needed medical care. These manipulations included exaggerating the severity of the patients’ condition, changing the billing diagnosis, or reporting symptoms the patient did not have. And 72% admitted using one of these tactics at least once in the past year. More than a quarter said that gaming the system was necessary in order to provide high quality care to their patients, and 15% asserted that it was ethical.”

“Another survey, published in the July/August, 2003, issue of Health Affairs, reported that nearly 33% of American doctors admit that they routinely withhold from their patients pertinent information about optimal medical treatments, because they suspect the patients’ health plans won’t cover those treatments.”

 

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Do Economists need an ethical code?

January 10, 2011 in Economics - General | No comments

American Sociological Association and the American Anthropology Association have a code of ethics.  Similarly, the American Psychology Associationand the American Statistical Association both have guidelines for ethics.  Does the American Economic Association need one for economists as well?

A recent petition by a group of economists called for just such a code. The petition has been covered in the New York Times and the Economist. The authors propose the following basic code:

“Economists should maintain the highest degree of integrity in their professional work and avoid conflicts of interest and the appearance of conflict. Moreover, economists should disclose relevant sources of financial support and relevant personal or professional relationships that may have the appearance or potential for a conflict of interest in public speeches and writing, as well as in academic publications.”

I do not think an ethical code that asks economists to ‘maintain the highest degree of integrity’ will have much of an effect on behavior.  First, most economists already know they should act with integrity.  Second, what body would enforce that economists act with integrity.  Without enforcement, the code would have little teeth.  However, the AEA is made up of a small clique of economists, few of who would expel their peers (and friends) from being an economist.

On the other hand, compelling economists to disclose their financial interest could be useful.  Almost every economist has their own homepage.  The code could compel economists to include a link to a webpage which lists the sources from which the economists receive income.  Again, enforcement could be a problem.  The AEA could check that the webpage is updated annually for each of their members.  It is unlikely, however, that the AEA would be able to verify the accuracy of these reports.

Thus, the code of ethics could promote more of a culture of disclosure among economists.  For instance, upon all economists could be required to sign the code of ethics upon defending their dissertation. Thinking that the code of ethics will turn corrupt economists honest, however, is unrealistic.  More likely, it will have a very marginal or no effect on economist behavior.

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