A Texas-based radiologist noticed strong disagreements among well-meaning physicians on many ethical issues. These included physician-assisted suicide, abortion, contraceptives, and cosmetic surgery.

“I hypothesized that if medicine lacked a unified mission, then that may be the cause of our internal disagreement,” says Christopher Lisanti, MD.

Lisanti and a colleague found the ethics statements of various U.S. medical organizations are inconsistent regarding the direct goals of medicine.1 They analyzed the ethics statements of 22 organizations and characterized each as traditional (18%), relational (9%), or social constructionist (73%).

Overall, there was significant inconsistency and lack of clarity on the direct goals of medicine. The study showed 33% to 53% of direct statements regarding the goals of medicine contained a fundamental philosophical disagreement.

“This leads to sometimes-conflicting concepts of physicians’ duties, the goals of medicine, and the patient/physician relationship,” Lisanti says.

Concurrently, many physicians are struggling with a changing physician-patient relationship. “More and more, physicians feel that they are no longer trusted health consultants, but merely drug or medical procedure vending machines for patients,” Lisanti argues, adding bioethicists “will likely face physicians and patients increasingly at odds with each other, since they do not agree on the purpose or goals of medicine.”

Ethicists can guide physicians to verbalize the philosophical assumptions driving opposing, sometimes heated, viewpoints. “This will promote mutual understanding,” Lisanti offers. “Hopefully, it will promote unity in an agreed-upon course of action for our patients.”

REFERENCE

  1. Lisanti C, Wolfgramm S. Does medicine have common goals? An analysis of US medical organizations’ ethics statements. Linacre Q 2021;88:202-213.