Professionalism vs. Medical Ethics in the Current Era: A Battle of Giants?

Abstract

This chapter focuses on the question, “Which norms should govern the practice and practitioner of medicine—and why those?,” and critically examines the partially overlapping, yet competing, answers given to this question by two rival paradigms: (1) “secular academic medical ethics,” and (2) medical professionalism. After clarifying the nature of both paradigms, the chapter presents a multifaceted case for favoring the norms of secular academic medical ethics. This case emphasizes professionalism’s tendency toward medical paternalism, its encouragement of a “peace in the house” of medicine culture that resists accountability to those outside of medicine, and its insistence on fiduciary standards that are overly demanding and perhaps unworkable in our current era of medicine.