The Physician-Patient Relationship in a Secular, Pluralist Society

Abstract

Medicine is practiced in secular, pluralist societies. In the United States and large areas of Latin America, Europe, and Japan, physicians and nurses find that their patients and colleagues are often moral strangers to them. They frequently do not share with their patients a common view of the good life or of the purposes and goals of health care. It is this circumstance that marks the moral predicament of the modern physician-patient relationship. This is not to deny that in many instances physicians do share with their patients common moral viewpoints or understandings. A Hassidic Jewish physician practicing in a Hassidic Jewish community, a Seventh Day Adventist in a Seventh Day Adventist hospital, a Roman Catholic practicing in a strict Roman Catholic hospital may be able to presume that his or her views concerning the fundamental nature of morals are shared with patients. That presumption, however, can usually not be made. Physicians and patients are likely to hold diverging views with regard not only to the moral probity of such widely employed interventions as contraception and abortion, but also with regard to the moral significance of pain, suffering, death, and life itself. Since concrete moral judgments require an appeal to a moral hierarchy of benefits and banes, differences in such hierarchies frame differences in world viewpoints and the significance of particular decisions.