Patient autonomy and the ethics of responsibility /

Tauber (Boston Univ.) presents a case for rehabilitation of the doctor-patient relationship, made necessary, he claims, by an unsatisfactory concept of patient autonomy. The author reviews the historical background, with purportedly value-free science pitted against subjective patient care, and shows that medicine has always involved more than scientific facts. He then examines the ways an ethic of care has been embedded, although unacknowledged, in medicine's prioritizing of interpersonal relationships. Tauber examines the concept of autonomy, with particular attention to selfhood and reason. His goal here is to formulate a concept of autonomy that is applicable in the world of patients, who are by the nature of illness living under what one might consider to be compromised autonomy. After arriving at this new concept of autonomy, Tauber brings physician beneficence into the dialogue to argue that it is not incompatible with patient autonomy, but requires modification by an assumption of responsibility for trustworthiness on the part of the physician. He concludes with practical suggestions for how this environment of enhanced trust between physician and patient might be fostered. ^BSumming Up: Recommended. Advanced undergraduates, graduate students, and researchers/faculty. P. R. Sailors Missouri State University