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Reconceiving the therapeutic obligation.

David Merli1, Joshua A Smith

  • 1*Department of Philosophy, Franklin and Marshall College, PO Box 3003, Lancaster, PA 17604-3003, USA. david.merli@fandm.edu.

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Summary

Physicians have a therapeutic obligation to provide the best available treatment. This study refines this duty, addressing suboptimal care and uncertain medical knowledge, offering a new framework for medical ethics.

Keywords:
randomized clinical trialssuboptimal treatment optionstherapeutic obligation

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Area of Science:

  • Medical Ethics
  • Philosophy of Medicine

Background:

  • The "therapeutic obligation" (TO) defines a physician's duty to offer the best treatment.
  • Existing formulations struggle with cases of permissible suboptimal care and uncertain medical knowledge.

Purpose of the Study:

  • To critically evaluate current definitions of the therapeutic obligation.
  • To propose and defend a revised account of the therapeutic obligation.

Main Methods:

  • Analysis of prominent formulations of the therapeutic obligation.
  • Development of a new theoretical framework for the TO.
  • Examination of challenging clinical scenarios.

Main Results:

  • Current TO formulations fail to account for situations permitting suboptimal care.
  • Existing models provide inaccurate guidance in uncertain epistemic environments.
  • A novel account of the therapeutic obligation is proposed and defended.

Conclusions:

  • The proposed TO framework resolves issues with suboptimal care and epistemic uncertainty.
  • Apparent challenges to the new proposal often stem from complexities in informed consent.