Help from Hume reconciling professionalism and managed care

Health care systems are widely criticized for limiting doctors' roles as pa tient-advocates. Yet unrestricted advocacy can be unfairly partial, costly, and prejudicial. This essay considers three solutions to the problem of ho w to reconcile the demands of a just health care system for all patients, w ith the value of advocacy for some. Two views are considered and rejected, one supporting unlimited advocacy and another defending strict impartiality . A third view suggested by Hume's moral theory seeks to square the moral d emands of professional advocacy and just health care systems. A moral basis for limited advocacy exists when it can be justified from a general or mor al vantage. Consequently, ethical aspects of professionalism are not necess arily on a collision course with health care systems incorporating managed care. This solution is compatible with goals regarding the importance of hu manistic education and professionalism to build patients' trust.