The Clinical Encounter

The encounter between patient and physician may be characterized as the focus of medicine. As such, the patient-physician relationship, or more accurately the conduct of patients and physicians, has been the subject of considerable comment, inquiry, and debate throughout the centuries. The issues and concerns discussed, apart from those more specifically related to medical theory and therapy, range from matters of etiquette to profound questions of philosophical and moral interest. This discourse is impressive with respect both to its duration and content. Contemporary scholars and laypeople have made their contribution to these long-standing discussions. In addition, they have actively addressed those distinctively modern issues that have arisen as a result of increased medical knowledge, improved technology, and changing cultural and moral expectation. The concept of the patient-physician rela tionship that supposedly provides a framework for the conduct of patients and physicians seemingly has taken on a life of its own, inviolable, and subject to norms particular to it. The essays in this volume elucidate the nature of the patient-physician relationship, its character, and moral norms appropriate to it. The purpose of the collection is to enhance our understanding of that context, which many consider to be the focus of the entire medical enterprise. The con tributors have not engaged in apologetics, polemics, homiletics, or em piricism.

Section I / Historical Inquiries and Perspectives. - Evolution of the Patient-Physician Relationship: Antiquity Through the Renaissance. - The Legacy of Modern Anglo-American Medical Ethics: Correcting Some Misperceptions. - American Medical Ethics and the Physician-Patient Relationship. - Section II / Models of the Patient-Physician Relationship. - Veatch, May, and Models: A Critical Review and a New View. - The Case for Contract in Medical Ethics. - A Rejoinder. - Legal Models of the Patient-Physician Relation. - The Common Law as a model of the Patient-Physician Relationship: A Response to Professor Brody. - Jewish Religious Law as a Model of the Patient-Physician Relationship: A Comment on Professor Brody s Essay. - Response to Franck and White. - Section III / Conceptual and Theoretical Analyses. - The Healing Relationship: The Architectonics of Clinical Medicine. - The Psychiatric Patient-Physician Relationship. - The Physician as Stranger: The Ethics of the Anonymous Patient-Physician Relationship. - The Internal Morality of Medicine: An Essential Dimension of the Patient-Physician Relationship. - Scope of the Therapeutic Relationship. - Section IV / Morality in the Patient-Physician Relationship. - The Physician-Patient Relationship in a Secular, Pluralist Society. - The Therapeutic Relationship: Is Moral Conduct a Necessary Condition? . - A Theological Context for the Relationship Between Patient and Physician. - Notes on Contributors.