Values, function, and managed care: An ethical analysis

This article examines how contemporary values emphasizing personal rights that in turn give rise to an ideology of robust individualism have exerted enormous influence in contemporary health care, especially in the allocation of rehabilitation services. The points of influence to be examined include the ways in which contemporary values discourage a sense of mutual obligation and shared responsibilities, alienate persons with disability from accessing opportunity, inspire and justify the contemporary phenomenon of managed care, and subordinate rehabilitation's time-honored goal of restoring function to a goal of economic feasibility. Suggestions are made for remedying these challenges, although an ideal solution will at least require a heightened appreciation of how the notion of shared social obligations enhances the pursuit of self-interest, especially when that pursuit is threatened by the onset of disability.