Americans have long assumed that their health care is the best in the world, but recent evidence has shown otherwise. Unnecessary surgery, inappropriate use of medications, and other medical errors are commonplace. One-third of American patients in a 2005 survey reported being victims of medical errors--more than patients in Australia, Canada, German, New Zealand, and the United Kingdom. There are also significant inequities, with the quality of care varying according to a patient’s socioeconomic status, ethnicity, and geographic location.
In response, many health care professionals have recently launched systematic efforts to upgrade the quality of care by making changes and monitoring their effects on an ongoing basis. That is good news and, on the surface, would seem to pose no ethical dilemmas. But there are several areas of concern.