Contending Images of the Healer
in an Era of Turnstile Medicine
WILLIAM F. MAY
The historian Martin Marty once observed that writing a book required a single, mastering idea that informed the whole. Marty himself enjoyed the inspiration of such an idea before drafting each of his books with the speed of Mozart. My writing ol The Physician's Covenant WAS quite the reverse. I wrote essays in biomedical ethics across the 1970s in response to specific invitations, which led to publication in scattered journals or books. The closest piece to a programmatic essay appeared in The Hastings Report (December 1975) under the title, “Code, Covenant, Contract, or Philanthropy?” All the essays that eventually made their way into the book underwent a scries of growth rings beyond their original planting. At length, a way of recognizing and describing a stand of trees emerged to define the whole. But I must confess I worked less like a French gardener at Versailles, imposing a formal design on a stretch of land, than like an English gardener, turning the soil a little here, pruning there, reseeding the bare spots, and hoping for some sun and rain. The result was The Physician's Covenant: Images of the Healer in Medical Ethics, which Westminster Press published in 1983 and brought out in a revised edition in 2000.
The subtitle of the book refers to several contending images for the healer. Why resort to images—such as parent, fighter, technician, contractor, covenanter, and teacher—rather than to moral principles or theories in the attempt to reflect ethically on medical practice? Most philosophers and theologians writing in medical ethics in the early 1980s were more interested in dilemmas (hard cases) than in the great overarching images