Health systems must work not only to protect a patient’s corporeal health but their financial health as well. In the United States, bankruptcies related to healthcare are the top cause of such filings and in 2011 about a third of U.S. families were either struggling to pay medical bills or defaulting on their payments. Logically, the doctor patient interaction while developing a treatment plan represents a good point at which to intervene however while physiological side effects of care are emphasized the pecuniary ones are rarely discussed.
I can understand the trepidation surrounding bringing cost into a clinical interaction. As we learned on Tuesday, our bodies are not like other commodities and are incredibly difficult to place in financial terms. Additionally, we have moral injunctions regarding the inherent pricelessness of a human life. Some doctors even hold discussing costs while constructing a treatment plan as a violation to “the doctor-patient relationship.” Considering two of the four central principles of medical ethics, respect for autonomy and non-maleficence, I argue the opposite. Without discussion of financial burden of treatment neither a fully-informed autonomous decision can be made by the patient nor are patients spared the harm of potentially crippling financial burdens which can further undermine their health. Better integrating financial discussions into treatment plans allows for selection of cheaper but equally effective interventions, the option of trading reduced medical benefit for less financial distress if the patient desires, and gives patients time to seek resources that can help them better finance care and avoid catastrophic health spending.
Doctors are extremely exacting in guaranteeing patients are made aware of even the minutest potential clinical side effects and I feel like this ethos should extend to financing as well given the very real risks associated with the rising cost of care.