By Søren Holm.
The rise of ‘professionalism’ as the panacea to all of the ills afflicting the medical profession has led to a resurgence of the idea that medical ethics should be professional ethics, and that the content of this professional ethics should be decided by the profession. In my comment “Roles, professions and ethics – a tale of doctors, patients, butchers, bakers and candlestick makers” I show that some of the arguments for this position are flawed.
There is, however an even more fundamental problem with the view that medical ethics should be professional ethics. That problem is that leaving medical ethics to the medical profession would roll back the last 50 years of progress in realigning the power dynamics between doctors and patients. Patients are rightly no longer patient, but are seen as equal partners in decisions about their own health. Letting the medical profession take back control of the ethics of the doctor-patient relationship will lead to a lop-sided ethics, because it will inevitably move the focus to one side of that relationship.
We know from history that professions have not been good at separating the interests of the profession in power and money, from the interests of patients and clients in professional conduct. And, anyone who claims that all this has changed and that the medical profession can now handle its conflicts of interest is mistaken. One only has to look at the strenuous efforts in many countries to keep other healthcare professions out of clinical decision-making roles traditionally occupied by doctors to see that the medical profession is still seeking to protect its power, privileges, and earnings.
Medical ethics is far too important to leave to doctors! The ethics of the medical profession (and all other health care professions) has to be decided in an open process involving all relevant stakeholders. In that process patients should have the most important voice; it is after all they who are most affected by the actions of medical doctors.
Author: Søren Holm
Centre for Social Ethics and Policy, Department of Law, University of Manchester, Manchester, UK
Centre for Social Ethics and Policy, Manchester University School of Law; Center for Medical Ethics, HELSAM, University of Oslo
Competing interests: None