Rationing Sanity

The ethical issues of managed care are more pronounced for mental health than for other areas, yet little systematic attention has been paid to them. Rationing Sanity makes a valuable contribution to the ongoing effort to rethink the importance of both professional and institutional values in the managed care environment. -- Larry R. Churchill, Ann Geddes Stahlman Professor of Medical Ethics, Vanderbilt University Medical Center Not only does Rationing Sanity include excellent new work on the ethics of allocating scarce resources in health care, but it also focuses on controversies in mental health. This important collection will significantly enrich the contemporary debate in medical ethics. -- Christian Perring, Department of Philosophy, Dowling College

Mental illness is the poor, and somehow "damaged," cousin to physical ailments in the eyes of too many in our society. This title presents a provocative analysis of the mental health care system in the United States, dealing with issues of justice and access to mental health care.Mental illness is the poor, and somehow "damaged," cousin to physical ailments in the eyes of too many in our society. Compare the difference in how people would respond to someone who had fallen and broken their leg on the street, to how most react to those mentally ill among us, on those same streets, who spend their winters on steam grates and forage for food in dumpsters. "Rationing Sanity" is a provocative analysis of the mental health care system in the United States, dealing with issues of justice and access to mental health care. How should a decent society, affluent but facing many serious calls on its resources, best care for citizens afflicted with severe and persistent mental illnesses? James Lindemann Nelson brings together, for the first time, scholars of the ethics of mental health care and top managed care policy analysts to address this crucial problem. "Rationing Sanity" integrates those perspectives with the thoughtful practice-based experience of physicians well versed in the actual care of people with emotional and behavioral problems. Over a period of years, the contributors met face-to-face to engage each other on the ethics of managed mental health care - the result is a unique, collaborative effort that provides a wealth of important new insights on not only how Americans can readjust their attitudes toward the mentally ill - but also how we may find more just and humane treatment for those afflicted.