Charity Care in Crisis: Reclaiming a Lost Professional Ethic

Abstract

The concept of “charity care” is a fundamental principle in the practice of medicine. This paper examines the origins of the construct charity, the expansion of charitable care during the Middle Ages, and its gradual secularization throughout the Renaissance and the Enlightenment. The paper then highlights the transformation of Almshouses, Infirmaries and Dispensaries into charitable institutions of medical science in the nineteenth century with the birth of progressivism during the early twentieth century. A conceptual model is then presented that depicts the erosion and qualitative changes in charity care as a result ofthe corporatization of health care over the course of the last century. The construct of charity care is now in crisis. The medical profession has gradually disassociated from its obligation of charitable care as an ethical precept for the practice of medicine. The paper ends with a challenge to reclaim and renew the importance of charity in the provision of health services.