The Physician-Societal Relationship

Autor: Gordon L. Crelinsten
Rok vydání: 1990
Předmět:
Zdroj: Business and Professional Ethics Journal. 9:79-82
ISSN: 0277-2027
DOI: 10.5840/bpej199093/421
Popis: The contemporary doctor-patient relationship is based on the competent patient's right to self-determination. After being adequately informed of treatment options, the competent patient has the right to choose or to refuse therapy. The physician has an obligation to provide medical and technical expertise. The goals of the encounter, however, are established by the patient based on personal values. These goals may include the preservation of life at all costs, the preservation of function, the maintenance of a given quality of life, or the relief of suffering. After a realistic goal has been ascertained, doctor-patient cooper ation can proceed. The doctor maintains the role of competently, efficiently and effectively assisting the patient to reach expected goals with reasonable anticipation of success. There is available a wide range of diagnostic and treatment technology that can be applied in most clinical situations. Specialist physicians, treating and preventing a narrow range of disease, advocate courses of action to solve and to cure their particular conundrums. Their patients, suffering from the same narrow range of disease, expect their due based on their perception of "the state-of-the-art," or care at all costs. From the individual perspective this co-operative approach may be just fine; however, from a societal point of view, if we cannot afford everything, then access to, or availability of something must be restricted.1 New technologies are efficient and effective, but they are expensive, and when the health goals being maximized are societal rather than individual, questions of distribution become important.2 Who gains and who loses by choosing to allocate certain resources? The gains and losses are magnified because of the proven benefits of expensive technology. Hemodialysis; sophisticated, mechanically complex cardiac pacemakers; orthopedic prostheses; transplantation
Databáze: OpenAIRE
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