The physician's virtues and legitimate self-interest in the patient-physician contract

I will be the first to admit that we are now well into uncharted territory of the patient-physician contract. I also detect missing stretches of my dermal layer and you may spy some that I have yet to notice. In any case, I put to your serious consideration the proposal that part of the patient-physician contract must include respect for the legitimate interests of the physician by patients and third parties. The virtues of self-effacement and self-sacrifice and the concept of legitimate self-interest help us to understand in concrete, clinically applicable terms what such respect means in practice. That respect will, I think, be expressed with some variability, because there is no simple algorithm for negotiating conflicts between legitimate self-interest and the virtues of self-effacement and self-sacrifice. One important consequence of this moral variability is that the patient-physician contract and the virtues that sustain it will not yield to a single, finally authoritative account of how such conflicts should be negotiated. Instead, as we turn more attention to these matters, we will, I believe, discover that there is a range or continuum of ways in which the management of such ethical conflict can reliably be understood in the patient-physician contract. Rather than a single account of the ethical dimensions of the patient-physician contract, we should expect to develop a range of reliable accounts. A kind of rich and engaging moral pluralism should thus govern our understanding of the ethical dimensions of the patient-physician contract.(ABSTRACT TRUNCATED AT 250 WORDS)