The agency problem and medical acting: an example of applying economic theory to medical ethics

• Published in: Medicine, health care, and philosophy Vol. 12; no. 1; pp. 99 - 108
• Main Authors: Langer, Andreas, Schröder-Bäck, Peter, Brink, Alexander, Eurich, Johannes
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 2009; Springer Nature B.V
• Subjects: Adverse selection; Attitude of Health Personnel; Bioethics; Decision making; Economic theory; Education; Empowerment; Ethics; Ethics, Medical; Health care policy; Health education; Health literacy; Humans; Internet; Medical ethics; Medical Law; Morals; Patient Advocacy - economics; Patient Advocacy - ethics; Patients; Philosophy; Philosophy of Biology; Philosophy of Medicine; Physician's Role; Physician-Patient Relations - ethics; Physicians; Practice Patterns, Physicians' - economics; Practice Patterns, Physicians' - ethics; Reimbursement, Incentive - ethics; Review Article; Theory of Medicine/Bioethics; Germany; Physician-patient relationship; Principal–agent theory; New institutional economics; Health care systems; Medical ethics
• ISSN: 1386-7423; 1572-8633
• DOI: 10.1007/s11019-008-9138-y

In this article, the authors attempt to build a bridge between economic theory and medical ethics to offer a new perspective to tackle ethical challenges in the physician–patient encounter. They apply elements of new institutional economics to the ethically relevant dimensions of the physician–patient relationship in a descriptive heuristic sense. The principal–agent theory can be used to analytically grasp existing action problems in the physician–patient relationship and as a basis for shaping recommendations at the institutional level. Furthermore, the patients’ increased self-determination and modern opportunities for the medical laity to inform themselves lead to a less asymmetrical distribution of information between physician and patient and therefore require new interaction models. Based on the analysis presented here, the authors recommend that, apart from the physician’s necessary individual ethics, greater consideration should be given to approaches of institutional ethics and hence to incentive systems within medical ethics.