Abstract

KIE: In one of a series of articles on philosophical medical ethics, Gillon considers the implications for medical ethics of the social context in which doctors practice. Such implications often contradict a common and absolutist medico-moral cliché that "the patient's interests always come first." He notes that moral obligations to a particular patient may at times be superseded by the social obligation to allocate health care resources justly; to pursue research to benefit future patients; and to engage in preventive medicine to benefit potential patients. Gillon also reflects on three more hidden aspects of medicine's relation with society that may conflict with the interests of the individual patient--the contribution of social factors to disease and health, social determinants of physician's attitudes, and the struggle for power between the medical profession and other social groups