Altruism in the Service of the Market and the State, and the Ethics of Regulation
When discussion of altruistic medicine is restricted to the behavior of vulnerable patients and individuals, the powerful stakeholders of the system are absolved of their obligation to altruism. While substantial agreement may surround the definition of “pure” altruistic action, the social context of inequity and power relationships could render it harmful or exploitative if such obligation is one-sided. The present commentary addresses the roles and obligations of other stakeholders within four aspects of the system. These include a) the behavior of the medical profession, b) the significance of the scaled-up altruism of common people, c) the state and its role in preserving the market to finance the public system, and d) the roles and responsibilities of the regulator who is to protect the altruists. The author’s commentary concludes with several additional questions and directions for researchers and policy-makers.
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