CHAPTER 2
The Patient-Doctor Relationship

Introduction

The Hippocratic model of medicine was very much a paternalistic one. The good doctor determined what was in his patient';s best interests, and the good patient was expected to follow the doctor';s recommendations. But patient autonomy is now an established concept in medical practice. Doctors have a fiduciary responsibility to patients, one that rests on a trusting relationship between them. As part of this responsibility, there is a presumption to treat patients when it offers them some medical benefit. A patient';s interests are not only physiological, however. Some treatments may conflict with a patient';s religious beliefs. Other treatments may cause enough pain and suffering to outweigh any benefits to the patient. As an expression of their autonomy, patients have the right to refuse even medically beneficial treatments on these grounds. Decisional authority rests not with the doctor, but the patient.

Acknowledging the importance of respect for patient autonomy and of informed consent for any treatment, are there some instances in which a physician can justifiably override a patient';s refusal and treat the person against his or her will? Can paternalistic intervention be justified at the expense of individual autonomy? Can a physician use a therapeutic privilege and not disclose potentially harmful medical information to a patient? Are there circumstances

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Biomedical Ethics
Table of contents

Table of contents

  • Title Page iii
  • Contents vii
  • Preface ix
  • Biomedical Ethics xi
  • Chapter 1 - History and Theories 1
  • Chapter 2 - The Patient-Doctor Relationship 23
  • Chapter 3 - Medical Research on Humans 47
  • Chapter 4 - Reproductive Rights and Technologies 71
  • Chapter 5 - Genetics 95
  • Chapter 6 - Medical Decisions at the End of Life 119
  • Chapter 7 - Allocating Scarce Medical Resources 143
  • Index 167
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