ELABORATE: Economic factors influencing doctors’ medical decisions-making: Ethical responsibility in modern cancer medicine


Possible economic influences on medical practice are summarised under the term “economisation” and are subject of current professional, social and political discussions. Nevertheless, the assessment and meaning of the term “economization” remains unclear. A fuzzy concept of economisation complicates both the exchange about the subject matter and the normative evaluation of practices. Especially oncology as a cost-intensive subarea of medical practice, lacks interdisciplinary conceptual and ethical studies on the characterization and normative evaluation of economic factors influencing oncological practice.

Within the framework of the interdisciplinary collaborative research project, in which medical ethics, oncology and health economics work closely together it is planned to characterise and define the term and concept of “economisation”, evaluate and describe economic factors influencing oncological practice with qualitative analysis, confirm the results in a quantitative analysis of insurance data and together with relevant stakeholders develop recommendations on how to deal with negative economic influences in oncological practice.
With combined expertise from oncology, medical ethics, and health economics this project pursues the following objectives:

Aims of the project:

  1. Identify relevant/ typical decision-making situations in inpatient and outpatient oncology practice and characterize the economic influence on those decision-making situations.
  2. Examine selected decision-making situations and possible influencing economic factors by a quantitative analysis of the billing data of a large statutory health insurance company.
  3. Identify and justify possible measures to appropriately manage influencing economic factors.
  4. Stakeholder evaluation of the results and derived recommendations with regard to different target groups and settings with concrete implementation proposals.

This Project is funded by German Cancer Aid (DKH).
Term: 2022-2025

Oncology / Medical Ethics

Ethics and Empirics

Health Economics

Heidelberg University

Medical Faculty

Heidelberg University Hospital

National Center for Tumor Diseases

Prof. Dr. med. Dr. phil. Eva Winkler,
Dr. Katja Mehlis,
Dr. med. Julia König MAE



University Halle-Wittenberg

Institute for the History and Ethics of Medicine

University Medicine

Prof. Dr. Jan Schildmann
M.A., Sabine Sommerlatte, M. mel.


University of Bielefeld

Faculty of Health Sciences

Health Economics and Health Management

Prof. Dr. Wolfgang Greiner
Birthe Aufenberg, M.Sc.