Models for ethical medicine in a revolutionary age. What physician-patient roles foster the most ethical realtionship?

9JL/tJT by ROBERT M. VEATCH ost of the ethical problems in the practice of medicine come up in cases where the medical condition or desired procecture itself presents no moral problem. Most day-today patient contacts are just not cases which are ethically exotic. For the woman who spends five hours in the clinic waiting room with two screaming children waiting to be seen for the flu, the flu is not a special moral problem; her wait is. When medical students practice drawing bloods from clinic patients in the cardiac care unit-when teaching material is treated as material-the moral problem is not really related to the patient's heart in the way it might be in a more exotic heart transplant, Many more blood samples are drawn, however, than hearts transplanted. It is only by moving beyond the specific issues to more basic underlying ethical themes that the real ethical problems in medicine can be dealt with. Most fundamental of the underlying themes of the new medical ethics is that health care must be a human right, no longer a privilege limited to those who can afford it. It has not always been that way, and, of course, is not anything near that in practice today. But the norm, the moral claim, is becoming increasingly recognized. Both of the twin revolutions have made their contribution to this change. Until this century health care could be treated as a luxury, no matter how offensive this might be now. The amount of real healing that went on was minimal anyway. But now, with the biological revolution, health care