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Overview
In this provocative new book a philosopher-physician explores issues of medical ethics involved in a physician's use of power. Drawing from literary works dealing with medical power-from Dostoevsky's "The Grand Inquisitor" to stories by Richard Selzer-Dr. Howard Brody argues that proposals to reduce or eliminate the power of the physician are misguided; instead, guidelines should be developed for the use of medical power so that the physician shares with the patient both information and the responsibility for deciding on appropriate treatment."Some years ago, Brody, a physician with both clinical and academic obligations, began wondering why the concept of power so seldom entered into discussions of medical ethics. . . . This solidly written and documented book is Brody's closely reasoned, thought-provoking analysis of that concept. . . . An excellent text for-besides all levels of medical education-law discussion groups and individuals interested in the modern role of medicine."-Booklist
"A book with an intellectual energy, literate style, and sturdy originality . . . We could not wish for a wiser guide than this book."-Michael Loudon, Lancet
"I find Brody's book fascinating. Surely, the concept of power is of critical importance in medical ethics. It is time that someone provide the serious, systematic examination of it that Brody offers. Brody is one of a very small group of physicians doing serious work in medical ethics. It is delightful to receive his newest contribution. His extensive use of literary material makes the chapters both novel and enjoyable reading."-Robert M. Veatch
Synopsis
Although the physician's use and misuse of power have been discussed in the social sciences and in literature, they have never been explored in medical ethics until now. In this book, Dr. Howard Brody argues that the central task is not to reduce the physician's power, as others have suggested, but to develop guidelines for its use, so that the doctor shares with the patient both information and the responsibility for deciding on appropriate treatment. Dr. Brody first reviews literary works dealing with medical power, from Dostoevsky's "The Grand Inquisitor" to stories by William Carlos Williams, Vonda McIntyre, and Richard Selzer. These works, he shows, reveal the healers' ambivalence over their own power and patients' fears of the abuse of power. Dr. Brody then points out important but neglected ethical issues that emerge from an analysis of power, such as the tension between care of individual patients and the pressures of the doctor's workload; the rescue fantasy that impels some physicians to extraordinary lengths to save a life; and the economic system, which rewards surgeons and other specialists more than it does physicians who spend time talking with patients about their problems. He also shows how the perspective of shared power can shed new light on standard topics in medical ethics--from informed consent and confidentiality to resource allocation and cost containment.