MEDICAL ETHICS TO THE FORE

In this essay, I want to share my perplexity with you about issues in medicine that are usually referred to as “ethical”. I was just as perplexed when I left medicine in March 2006 as when I entered medicine in 1970. I am going to tell you why I am perplexed about ethical issues and why I think everybody else should be and then suggest how we might live with or within our perplexity.

Everybody knows why ethical issues are hot, and indeed getting hotter. First, there is survival against the odds. Many people now, as a result of medical advances, live on in states that none of us would wish upon our worst enemies. There is also the issue of consumerism. Once there were patients, then there were clients, now there are users and then ultimately there are litigants: that is roughly the evolution of a patient. One of the aspects of consumerism is the feeling that “Basically, I am no longer going to listen to these doctors, these women or men who are telling me what is good for me, I am going to challenge everything they say, just as I would challenge everything that I am told by the chap who services my car.” Behind this, there is a culture of suspicion: the default assumption that we should always be suspicious of those who pretend they have any kind of authority when they are talking to us.