Has anyone heard of this?  I would have thought that this would
be blatently unethical.  Imagine having as a pre-condition for
psychotherapy the requirement of the client having to participate
in a psychological experiment. Below I reproduce the first couple
of paragraphs from an article/commentary on CED from the current
issue of the Journal of the American Medical Association (JAMA).

-Mike Palij
New York University
[EMAIL PROTECTED]

http://jama.ama-assn.org/cgi/content/full/296/8/988

Medicare's Requirement for Research Participation as a Condition of
Coverage:  Is It Ethical?

Steven D. Pearson, MD, MSc; Franklin G. Miller, PhD; Ezekiel J. Emanuel, MD,
PhD

JAMA. 2006;296:988-991.
Vol. 296 No. 8, August 23/30, 2006

Policy makers agree that the US health care system needs new and better ways
to ascertain the risks, benefits, and costs of new medical technologies as
they are introduced into practice.1-3 One central policy mechanism to
develop such evidence is to link insurance coverage with a requirement that
patients participate in relevant research, including registries and clinical
trials. Medicare has introduced its own version of this approach, termed
coverage with evidence development (CED), and has used it in several
high-profile coverage decisions.4 But the policy has been criticized as
coercive and unfair.5 The future of CED at Medicare and of similar
approaches among private insurers may well depend on whether such approaches
are viewed as ethical.

In this article, we argue that CED should not be viewed as coercive because
Medicare patients are not entitled to new technologies that would not
receive coverage in the absence of CED. We discuss the ethical role of cost
concerns in selecting new technologies to receive coverage through CED; the
importance of embedding CED in a coverage decision-making process that sets
explicit standards for evidentiary review; and whether CED can play an
important, ethically legitimate role in balancing needs for better evidence
of effectiveness with the needs and desires of patients for rapid access to
new innovations.





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