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David L. Hartsuch, MS, CPA
University of Minnesota Minneapolis

JAMA. 1993;269(14):1789-1790.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—In the article "What Are We Teaching About Indigent Patients?,"¹ Miles is highly critical of a private hospital's refusal to treat an indigent patient, and challenges the ethicality of referring such patients to county hospitals in lieu of accepting medical assistance as payment. Miles' assumption that this is an unethical practice is based on the ethic of egalitarianism. I believe that there are a variety of other valid ethics that Miles has ignored, and that teaching ethics based solely on egalitarianism may foster a system that sacrifices the quality of care for the majority and prevents physicians from achieving the greatest good.

The sad truth is that all organizations must recover their operating costs to continue performing their mission to the community. Regardless of the most noble intent, all benevolence must have a benefactor. Recognizing this fact, many hospitals have established charitable foundations to dispense resources . . . [Full Text PDF of this Article]

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