Abstract
At the center of medical morality is the healing relationship. It is defined by three phenomena: the fact of illness, the act of profession, and the act of medicine. The first puts the patient in a vulnerable and dependent position; it results in an unequal relationship. The second implies a promise to help. The third involves those actions that will lead to a medically competent healing decision. But it must also be good for the patient in the fullest possible sense. The physician cannot fully heal without giving the patient an understanding of alternatives such that he or she can freely arrive—together with the physician—at a decision in keeping with his or her personal morality and values. In today's pluralistic society, universal agreement on moral issues between physicians and patients is no longer possible. Nevertheless, a reconstruction of professional ethics based on a new appreciation of what makes for a true healing relationship between patient and physician is both possible and necessary.
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Additional information
Dr. Pellegrino is Director of the Joseph and Rose Kennedy Institute of Ethics and John Carroll, Professor of Medicine and Medical Humanities at Georgetown University. This essay, a distillation of his many writings on the human side of medicine, was prepared for oral presentation to a predominantly lay audience at the Cedar Lane Forum on Medicine and Society, Bethesda, Maryland, February 11, 1982. For those interested in pursuing the subject in greater historical and philosophical depth, he now provides the list of references that follows the essay. He is also the author of a work in process of publication, “a third volume which will deal with the vexing question of the good of the patient.”
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Pellegrino, E.D. Toward a reconstruction of medical morality. J Med Hum 8, 7–18 (1987). https://doi.org/10.1007/BF01119343
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DOI: https://doi.org/10.1007/BF01119343