Doctors favor patient over law

Physicians often decide in favor of the patient when faced with an ethical decision whether to certify patients for disability, according to a recent study.

William Zinn, MD, and Nobuyuki Furutani, MD, of Harvard University in Cambridge, MA, surveyed almost 450 physicians, uncovering their ethical bind when deciding whether to grant patient requests for welfare disability certification (J Gen Intern Med 1996; 11:525-532). The physicians try to comply with the law, but often decide the patient’s interests are not best served by a strict interpretation, the study found.

Thirty-nine percent of a random sample of physicians "reported a willingness to exaggerate clinical data to help a patient they thought deserving of welfare disability benefits." Over half of those associated with neighborhood health centers reported the same willingness.

Of the entire sample, 62% of physicians reported that determining welfare disability eligibility was a conflict of interest, and 80% thought it would be better if an independent group of physicians were designated to determine disability.

About one-fourth of the patients who receive disability certification from physicians do not actually meet disability criteria, the researchers say.

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