Tag Archives: Hippocratic Oath

Power and Authority in the Patient/Physician Relationship in Western Medicine

The largest disparity between position in the social hierarchy of Western medicine is between the patient and the physician. The patient/physician interaction is critically shaped by the rigidity of the social hierarchy. In describing the nature of the patient/physician relationship, Parsons lays out four distinct features that establish and maintain a particular form of the subordinate/superior relationship, most commonly expressed in terms of power/authority.

Before going further, an extremely important distinction must be drawn. Power and authority are, categorically, not the same things. For instance, in at least one form, the legitimization of authority allows one to exercise more power. Authority therefore enhances elements like one’s reputation or one’s social standing. Authority, also, could be viewed as an entirely different form of power. Whereas power may stipulate the explicit use of force/coercion (i.e. violence), authority may stipulate a softer version of that with similar end results but without the use of force/coercion. Instead, psychological mechanisms and tools may be utilized. I don’t want to go too far down the rabbit hole on this, but suffice it to say they are conceptually and logically distinct and should be kept that way for current purposes.

In this case, the physician is bestowed with authority through his/her extensive knowledge of the human body, coupled with the recognition of the former by the social structure known as medical school. The authority of the physician allows him/her to suggest, recommend, and, in some cases, command the patient to complete or permit certain actions.

Continue reading

Moral Reasoning in the Context of Physician Assisted Suicide (PAS)

A Statement of Values — Proponents versus Opponents

Collectively, the proponents of physician assisted suicide value personal autonomy and responsibility, the quality of life, and compassion towards others. Proponents of physician assisted suicide feel that by being allowed to choose between life and death as a personal and medical decision, patients are able to exercise personal autonomy, a freedom that they take to be fundamental to the nature of humanity. This autonomy ties directly into their perceptions about quality of life, in that some view life as undesirable or lackluster if they are not able to enjoy activities, events, and relationships that they previously did due to terminal or incurable medical conditions. They do not view life as inherently valuable and worth living, but derive life’s value from its pragmatic and functional elements. When the level and intensity of physical and mental suffering crosses a certain threshold, these proponents value the actions of those who will show compassion and act in accordance with their final wishes. Thus, proponents of physician assisted suicide feel obligated to protect the personal rights of patients as well as to ensure that they are being treated with compassion to alleviate their pain and suffering. Any events or legislation that interfere with those conditions are intolerable.

Continue reading

Conscientious Objection: Some Thoughts

What I think I find most problematic about Conscientious Objection, or at least what lays the groundwork of my distaste for it, is its unique context. To put it more straightforwardly, Conscientious Objection can, but does not always, involve genuine cases of life and death.

Rather than considering one-off examples, let’s try a cluster approach.

i. A woman is in dire medical need of an abortion; if she does not receive an abortion, she will inevitably die during childbirth. If she lives, the fetus will die and vice versa.

ii. A woman is in significant medical need of an abortion; if she does not receive an abortion, she will inevitably suffer permanent physiological damage. If the fetus lives, she will live but in immense pain for the rest of her life. If she lives (i.e. has an abortion), the fetus will die.

iii. A woman is not in any medical need of an abortion; she elects to abort the fetus within the federally and state regulated timelines allowed to do so.

Continue reading

A Typological Sketch of Various Arguments Against Physician-Assisted Suicide

Physician-Assisted Suicide/Physician-Assisted Death/Voluntary Euthanasia
(*henceforth PAS/PAD/VE)

In what follows, I will present a brief typology of some of the various arguments that are commonly raised against PAS/PAD/VE. This typological sketch will proceed in broad strokes. The general categories that I used to group these various arguments are: methodological arguments, consequentialist arguments, legal arguments, epistemological arguments, and moral arguments.

To the Five Burroughs (Methodological, Consequentialist, Legal, Epistemological, and Moral)

Continue reading