Ethics, as it is applied to decision making in managed health care, is a growing area of debate. Mackie and Sim (2004) agree, and state in their editorial that the issue of ethical decision making is looming very large for public health. While the ethics of individual clinical decisions have long been explored, public health ethics have more recently become prominent. Decision making in managed health care is not just about the financial, legal and operational interests of the insurer but it also includes societal and medical interests of the patient. A balanced approach is therefore advocated to ensure good clinical practice is achieved in the interest of patients and simultaneously ensuring the financial sustainability of the private health insurer market. Thus the prerequisite of opening the debate of enabling ethical decision making in managed health care.

Carapinha, J. (2005) Ethical Decision Making in Managed Health Care. South African Pharmaceutical Journal, 72 (2).