The Healer's Power - Softcover

Brody, Howard

Softcover

ISBN 10: 0300057830 ISBN 13: 9780300057836

Publisher: Yale University Press, 1993

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 powers 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.

About this title

From Kirkus Reviews

Physician Brody, director of the Center for Ethics and Humanities in the Life Sciences at Michigan State, offers new perspective on and fresh insights into medical ethics. Arguing that the central ethical problem in medicine is the responsible use of power, Brody draws on literary examples as well as the literature of medical ethics. In an unusual opening, he borrows freely from Dostoyevsky's chapter ``The Grand Inquisitor'' in The Brothers Karamazov to present the powerful ``Chief of Medicine'''s views on the proper use of the physician's power. Brody then contrasts this view with that provided by the healer known as ``Snake'' in Vonda McIntyre's short story ``Of Mist and Grass and Sand'' (reprinted in the appendix). Brody sees the physician's power as having three components: Aesculapian, based on knowledge of medicine; charismatic, based on the physician's personal qualities; and social, derived from the physician's status in society. His guidelines for responsible use of this power are that it be exercised to bring about a good outcome for patients; that physicians share power with their patients by informing them, in so far as patients wish, about the nature of their illness and the proposed treatment; and that physicians be sensitive to their patients' sense of powerlessness. Brody applies these guidelines to issues that commonly arise within medical ethics--informed consent, confidentiality, quality of life, etc.--and some less commonly discussed, such as the physician's income. Although his discussion is not comprehensive--ethical questions involving reproductive technology, brain death, medical research, and behavior control, for example, are not explored here--Brody offers a new conceptual framework for analyzing them. Erudite yet accessible: an excellent springboard for discussion of a compelling subject. -- Copyright ©1991, Kirkus Associates, LP. All rights reserved.

About this edition

• Publisher: Yale University Press
• Publication date: 1993
• ISBN 10: 0300057830
• ISBN 13: 9780300057836
• Binding: Paperback
• Number of pages: 324