The Fragile Web of Responsibility: AIDS and the Duty to Treat

Abstract

Arras maintains that the AIDS crisis confronts society with the need to re-examine the proper role and duties of physicians and of the medical profession. He rejects as ethically unacceptable and practically unworkable duties to treat based either on a voluntary, contractual physician patient relationship or on a social contract with the profession. Although a virtue-based approach upholds an individualized duty to treat, it depends upon society's shared concept of the good which is beginning to erode as AIDS is viewed as a problem of a stigmatized minority. Arras concludes that the medical profession and society must decide whether to reaffirm the ideal of self sacrifice for patient benefit or--in keeping with the recent drift to the entrepreneurial, scientific, or bureaucratic models--to accept a self-centered role for physicians that would signify moral failure and set a dangerous precedent.