Patient as Citizen: Pluralism, Persuasion, and Liberal Politics

The tyranny of compassion is a consequence of defaulting to the model of patient as citizen. Borrowed from Rawls's liberalism, this is the notion that everyone should be free and equal. Hordern's attempt to recover compassion is an attempt to recover a fuller account of the political person - the citizen - as more, not less, than free and equal. The physician enters into a covenantal relationship of reciprocity with the patient, enabling persuasion beyond just shared decision making. This sort of relationship has implications not only for the clinic, but also as a potential source of repair in the broader political sphere.