Unsung Questions of Medical Ethics

Abstract

Barnard defines as the unsung questions of medical ethics those values implicit in the routines of everyday medical practice that determine the roles and responsibilities of both physician and patient. Based on the premise of curing physical disease, the physician's approach to the patient is materialistic, activistic, and benevolently authoritarian. The author maintains that these values contradict and undermine the official, increasingly patient-centered values of respect for patient autonomy and patient participation in decision making. Patient participation cannot be grafted onto current practices but must follow recognition of the values underlying these practices and reform of the structure of practice based on a commitment to patient-centered norms. (KIE abstract)