Ethische aspecten van marktdenken in de geestelijke gezondheidszorg.

Which moral consequences are implied in conceiving mental health care delivery as a market? It is argued that the market, as a term, does not function as a description of what actually occurs, but as a metaphor, albeit an effective one, which structures the behavior of managers and administrators. Three models of mental health care are described, including the moral principles, which prevail in each of them. In the Dutch situation there, in fact, appears to be a mix of these models. Competition between health care providers according to the principles of the free market burdens the patient-physician relationship, as relation of trust; it offers a potential threat to the principles of justice and solidarity; and to the autonomy of the medical profession. These hazards are illustrated by focusing on different types of markets.