The Journal of clinical ethics
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In their commentary on the recent report on the ethics of managed care by the American Medical Association's (AMA) Council on Ethical and Judicial Affairs, Miles and Koepp offer two salient criticisms: For one thing, they fault the Council for not disclosing how intellectual, legal, and financial conflicts of interest may have influenced the Council's ethical opinions. Specifically, they point to the AMA's customary interest in preserving the fee-for-service system and in avoiding potential litigation that might arise from strictures imposed on rulings of the Council on Ethical and Judicial Affairs by the Federal Trade Commission (FTC). For another, Miles and Koepp decry the Council's focus on the ethical obligations of individual physicians to their own patients to the neglect of their obligations to the healthcare plan, the other patients in the plan, and to society at large. ⋯ I do not agree with them, however, that disclosure of interests would help to judge the ethical validity of the Council's opinions, except in a limited way. Lest I be suspected of a conflict of interest, I must state at the outset that I had no part in drafting the Council's report and that I have no personal or intellectual commitment to fee-for-service per se. The report did cite a work of mine, however, and I do have an interest in clarifying its relevance to the issues in question.