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Medical Journal Editor Criticizes Health Care

By Andrew D. Cohen

The editor of the New England Journal of Medicine told the Class of 1990's Phi Beta Kappa members yesterday that the increasing commercialization of medicine is compromising the ethics which used to govern the profession.

The speech, delivered by Professor of Medicine Arnold S. Relman, was the annual oration of the Phi Beta Kappa Literary Exercises, an event that dates back to the selective academic society's founding at Harvard more than 200 years ago.

"The relation between physicians and patients is supposed to be quite different from that of businessmen and customers," Relman said in his speech, entitled, "Professional Ethics and Market Economics in America: Can They Coexist."

Relman said that traditionally, physicians would sacrifice financial interests for their patients, while those who tried to turn medicine into a profit-earning business were labeled charlatans and quacks.

But in the last two decades, the growth of the biomedical industry has made health care more commercial, and doctors have become more competitive as specialization within the profession increased, Relman said.

The federal government has encouraged this free-market approach to medicine, Relman said. In 1975, the Supreme Court declared antitrust laws applicable to the medical profession, encouraging competition among physicians, he said.

The result, Relman said, is that doctors are gaining a large financial stake in their own practice--a conflict of interest that would have never occurred under the old physician's code of ethics.

"If health care is not a business then we must not allow our physicians to be businessmen and our hospitals to be businesses," Relman said.

It will not be easy to find a solution to the problem, he said, but it is necessary for the nation to start by examining its objectives and values with respect to health care.

"We will have to painfully grope our way toward a health care system that will be worthy of our aspirations," Relman said.

The literary exercises also included a poetry reading by Louise Gluck, songs by the Harvard-Radcliffe Commencement Choir and the announcement of honorary members of Harvard's Alpha Chapter and Radcliffe's Iota Chapter of Phi Beta Kappa.

Also announced were three Phi Beta Kappa awards for excellence in teaching. The recipients, who were nominated by undergraduates, were Associate Professor of Literature and of Comparative Literature Christopher S. Braider, Assistant Professor of Computer Science Meichun Hsu and Associate Professor of Sociology Lenore J. Weitzman.

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