Abstract
Physicians derive their authority from at least two sources. Their moral authority is based on the obligation to place patient benefit above self-interest, which is reflected in professional codes of ethics. Technical authority arises from the physician’s superior knowledge about the course of disease and means to prevent, reverse, or arrest it. In the physician-patient relationship, the basis for moral authority is a patient’s trust of the physician. In health policy, moral authority hinges on public trust of physicians’ aggregate motivations (i.e., are physicians interested in service or money?). These bases for moral authority have until recently been widely presumed to be healthy and stable.
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Bibliography
Blume, S. S.: 1985, ‘The Significance of Technological Change in Medicine: An Introduction’, Research Policy 14 173–177.
Braunwald, E.: 1977, ‘Coronary-Artery Surgery at the Crossroads’, New England Journal of Medicine 297, 661–663.
Chassin, M. R., Brook, R. H., Park, R. E., etc. et al.: 1986, ‘Variations in the Use of Medical and Surgical Services by the Medicare Population’, New England Journal of Medicine 314, 285–290.
Committee for Evaluating Medical Technologies in Clinical Use, Institute of Medicine: 1985, Assessing Medical Technologies, National Academy Press, Washington, DC.
Daniels, N.: 1985, Just Health Care, Cambridge University Press, New York. See especially Chapter 6.
Faden, R. R., Beauchamp, T. L., in collaboration with King, N. M. P.: 1986, A History and Theory of Informed Consent, Oxford University Press, New York. See especially Chapters 3 and 4.
Fletcher, J. C.: 1983, ‘Moral Problems and Ethical Issues in Prospective Human Gene Therapy’, Virginia Law Review 69, 515–546.
Friedman, E.: 1986, ‘Practice Variations: Where Will the Push to Fall in Line End?’ Medical World News (January 27), pp. 51–69.
Fries, J.: 1980, ‘Aging, Natural Death, and the Compression of Morbidity’, New England Journal of Medicine 303, 130–135.
Haug, M. R., and Lavin, B.: 1981, ‘Practitioner or Patient — Who’s in Charge?’ Journal of Health and Social Behavior 22, 212–229.
Hiatt, H.: 1977, ‘Lessons from the Coronary Bypass Debate’, New England Journal of Medicine 297, 1462–1464. See also the adjacent correspondence section, pp. 1464–1470.
Himmelstein, D. U., and Woolhandler, S.: 1986, ‘Cost without Benefit: Administrative Waste in U.S. Health Care’, New England Journal of Medicine 314, 441–445.
Horrobin, D. F.: 1978 Medical Hubris, Eden Press, Montreal, and Lunesdale House, Hornby, Lancaster, England.
Jonsen, A.: 1983, ‘Watching the Doctor’, New England Journal of Medicine 308, 1531–1535.
Katz, J.: 1984, The Silent World of Doctor and Patient, Free Press, New York.
Light, D. W.: 1983, ‘Is Competition Bad?’ New England Journal of Medicine 309, 1315–1319.
Lowrance, W. W.: 1985, Modern Science and Human Values, Oxford University Press, New York.
Mullan, F., and Jacoby I.: 1985, ‘The Town Meeting for Technology’, Journal of the American Medical Association 254, 1968–1972.
Nozick, R.: 1974, Anarchy, State and Utopia, Blackwell’s Oxford. See especially Chapter 3.
Office of Technology Assessment, U. S. Congress: September 1982, Strategies for Medical Technology Assessment, Government Printing Office, Washington, DC.
Office of Technology Assessment, U. S. Congress: December 1984, Human Gene Therapy, Government Printing Office, Washington, DC.
Office of Technology Assessment, U. S. Congress: June 1985, Technology and Aging in America, Government Printing Office, Washington, DC.
Office of Technology Assessment, U. S. Congress: October 1985, Medicare’s Prospective Payment System, Government Printing Office, Washington, DC.
Perry, S.: 1986, ‘Technology Assessment: Continuing Uncertainty’, New England Journal of Medicine 314, 240–244.
President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research: June 1982, Compensating for Research Injuries, Govern ment Printing Office, Washington, DC. See especially Chapter 2.
Rawls, J.: 1971, A Theory of Justice, Harvard University Press, Cambridge, MA. See especially Chapter 3.
Reilly, P.: 1977, Genetics, Law and Public Policy, Harvard University Press, Cambridge, MA. See especially Chapter 2.
Relman, A. S.: 1985, ‘Cost Control, Doctor’s Ethics, and Patient Care’, Issues in Science and Technology 1,Winter, 103–111.
Relman, A. S.: 1985, ‘Dealing With Conflicts of Interest’, New England Journal of Medicine 313, 749–751.
Schneider, E., and Brody, J.: 1983, ‘Aging, Natural Death, and the Compression of Morbidity: Another View’, New England Journal of Medicine 309, 854–856.
Starr, P.: 1982, The Social Transformation of American Medicine, Basic Books, Inc., New York. See especially Chapter 5.
Steinwachs, D. M., Weiner, J. P., Shapiro, S. et al.: 1986, ‘A Comparison of the Requirements for Primary Care Physicians in HMOs with Projections Made by the GMENAC, New England Journal of Medicine 314, 217–222
Wennberg, J.: 1986, ‘Which Rate is Right?’ New England Journal of Medicine 314, 310–311.
Other References Consulted
Heilbroner, R. L.: 1985, The Nature and Logic of Capitalism, Norton Press, New York.
Ziman, J.: 1978, Reliable Knowledge: An Exploration of the Grounds for Belief in Science, Cambridge University Press, New York.
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© 1988 D. Reidel Publishing Company
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Cook-Deegan, R.M. (1988). The Physician And Technological Change. In: King, N.M.P., Churchill, L.R., Cross, A.W. (eds) The Physician as Captain of the Ship. Philosophy and Medicine, vol 29. Springer, Dordrecht. https://doi.org/10.1007/978-0-585-27589-5_8
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DOI: https://doi.org/10.1007/978-0-585-27589-5_8
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