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Physicians and obligatory social activism

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Abstract

This essay examines the claim that physicians have a special obligation to engage in social and political activism. Four ethical paradigms are considered. Two paradigms, the preventive medicine and the social medicine models, embody a limited professional obligation to advocate the priority of health in society; the justification for a more aggressive stance is limited by the failings of paternalism. The radical model and the heroic model speak to issues of personal virtue rather than professional obligation; they are not strictly comparable.

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Reference notes

  1. Oliver Wendell Holmes, “The Young Practitioner.” InWorks. Cambridge, Mass.: The Riverside Press, 1904, Vol. IX.

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  2. Cited in Proffer, E, Proffer CR.The Early Plays of Mikhail Bulgakov. Bloomington, Indiana: Indiana University Press, 1972, xxiv.

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  3. Kuhn, T.S.The Structure of Scientific Revolutions. 2nd Edition. Chicago: University of Chicago Press, 1970, pp. 10–11. See too, pp. 23–24, and 43 ff.

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  4. Cohen, I.B.Revolution in Science. Cambridge: The Belknap Press of Harvard University Press, 1985. See discussions pp. 26–27, 518–519.

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  5. Kuhn, in his 1969 postcript toStructure of Scientific Revolutions, does distinguish between two senses of paradigm: a sociological sense that stands for “the entire constellation of beliefs, values, techniques,” etc., of a “previously determined scientific community,” and another sense in which one element of that constellation, “employed as models or examples, can replace explicit rules as a basis for the solution of the remaining puzzles of normal science” (p. 175). I would suggest that both these sense have epistemic and attitudinal components. Available space does not permit the full exposition of this argument.

  6. Kuhn,Structure of Scientific Revolutions, pp. 157–159.

  7. Kuhn,Structure of Scientific Revolutions, p. 175.

  8. see Kuhn,Structure of Scientific Revolutions, p. 191 ff.

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Authors and Affiliations

  1. the Neurosurgery Service of Walter Reed Army Medical Center and The Kennedy Institute of Ethics, Washington, D.C.

    T. Forcht Dagi MD, MPH, MTS (FACS)

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  1. T. Forcht Dagi MD, MPH, MTS
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The opinions expressed in this article are the private views of the author and should not be construed as representing the policies or the views of the Department of the Army or the Department of Defense.

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Dagi, T.F. Physicians and obligatory social activism. J Med Hum 9, 50–59 (1988). https://doi.org/10.1007/BF01115243

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  • DOI: https://doi.org/10.1007/BF01115243

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