ETHICAL CAUTIONS IN THE USE OF OUTCOMES FOR RESOURCE-ALLOCATION IN THE MANAGED CARE ENVIRONMENT OF MENTAL-HEALTH

Increasingly, resources are being allocated through competitive contra cting based on outcome data. This context for outcome research renews ethical concern about the nature of outcome data in the field of menta l health. The epistemology of mental illness creates special concerns regarding outcome measurement. Ethical cautions specific to six types of outcome measurement are reviewed: utilization, clinician reports, p atient reports, objective measures of diagnostic entities, objective m easures of functioning and multifactor research. Brief guidelines are offered for addressing ethical cautions. Also discussed are the diffic ulty In defining good outcomes and a social obligation to future gener ations that may be better addressed through process measurements. Copy right (C) 1995 by W.B. Saunders Company