Lay obligations in professional relations

Abstract

Little has been written recently about the obligations of lay people in professional relationships. Yet the Code of Medical Ethics adopted by the American Medical Association in 1847 included an extensive statement on "Obligations of patients to their physicians'. After critically examining the philosophical foundations of this statement, I provide an alternative account of lay obligations in professional relationships. Based on a hypothetical social contract and included in a full specification of professional as well as lay obligations, this account requires lay people to honor commitments and disclose relevant information. Ethically, the account assumes that all parties in lay-professional relationships should be given equal consideration and respect in determining rights and obligations. Factually, it assumes that the treatment of many illnesses and injuries required collaboration and cooperation among lay persons and health professionals, that medical resources and personnel are limited, and that medicine, nursing, and related health professions, are, in MacIntyre's sense, practices.

KIE: The author explores the question of what obligations patients and potential patients owe to physicians and other health professionals. While the code of ethics adopted by the American Medical Association at its founding in 1847 laid great stress on patient obligations, it did so from a conceptual standpoint of one-sided indebtedness on the part of the patient. Benjamin posits a theory of patient obligation based on a hypothetical contract between the lay person and the health professional. Assuming that treatment often requires collaboration and cooperation between the two, that the availability of medical resources is limited, and that professional practice has inherent standards and integrity worthy of respect, he assigns two types of prima facie obligation to the lay person in the lay-professional relationship: to honor commitments and to disclose relevant information.