Professionalism, Autonomy, and Medical Progress
To depend upon a profession is a less odious form of slavery than to depend upon a father.
Americans have become so enamored with the idea of medical progress that many believe physicians will soon unlock the mystery of why their bodies decay and die. Through appropriate medication, personal trainers, and diet, they hope to maintain a kind of perpetual biological middle age, if not the vigorous physical bravado of young adulthood. Until they reach this medical golden age, they seek to overcome their fear of future disability and dependence by appealing to an ideology of "professionalism," "autonomy," and "medical progress."
Within this peculiarly Western ideology, professionals and patients are atomistic. Patients--unstitched from their own self-conceptions as sons, daughters, parents, or friends--are the quintessential individuals. "Mentally competent" patients can weigh the risks and benefits of any proposed course of treatment or nontreatment. Modern health care professionals' sole obligation is patient well-being. Science-based education prepares physicians for continuous learning and innovation in practice. Their own individual consciences provide penetrating judgments about individual patients' needs and desires. In this scientistic world view,