Question

A. What are the professional codes of physicians or medical societies based upon? Are they ethical codes? If not, what are they? If so, how are they ethical? What purpose (s) do such ethical codes serve?

B. Describe the following models for the doctor-patient or scientist-subject relationship and discuss any problematic characteristics of each.

1. Code

2.Contract

3. Covenant and Consent as a Canon of Loyalty

Answer 1

Three models of the relationship between health provider and the Recipient areThe three models are

1.Code

2.Contract

3.Convenant

1.CODE

The model is based on code is one that harkens back to the mediaeval guilds.There are written and unwritten, traditional guides and rules to geovern the conduct of the members of the gulid.The purpose of such regulations is the development and maintenance of techincal proficiency.The knowledge and skills of the members bof the guild is of greatest importance and value.

There are written and official pronouncements made by governing authorities of the guilds and the aim is to faster a sort of etiquette among guild members and promotethe members and to promote the members rendering service tto those outside of the guild but as a matter of philanthropy and not outvof obligation to any fellow members of the guild.Members of such professional associations have their own special language and often have intiation rites and are under an obligation of secrecy concerning the inner workings of the profession.Members have duties towards one another.

Members have deep feeling of solidarity which has them support one another and to be more cooperative rather than competative.There would be a sort of anti-compitative monopolistic practices such as price fixing including the use of a sliding scale in order to maximize income.

For the members of professional organisations the overacting aim appears to create those institutions and practices that provide for a life style ,an image ,a sense of decorum and basically a beautiful life.The codes aim for the realisation of an aesthetic ideal.Concerm for colleagues is greater than that for those served.Five factors militate against self critisism and self regulation are

1.Sense of community -this is very strong

2.Power of the priestly caste - this is undermined by doubts and questions raised by colleagues.

3.Power of the modern physician unstable -based on power over death - undermined by admission of limitations.

4.Suspicion of officiousness , injustice,hypocrisy caused by the special language , attitudes and secrecy of guild members.

5.Basic conflict - there are two sets of obligations:to guild and to patient.

2.CONTRACT

In the contractual model there is a certain symmetry in the relationship of the members of medical profession and those for whom they render service.They are seen as nearly equal parties engaged in a voluntary association for mutual benefit.This model is one promoted in a time of frequent litigation.The enforcers of contracts promote envisioning the basic relationship between human beings in terms of an instrument that has a feature of legal enforcement.

It is a model in which the participants are seen as singularly motivated by self-interest and not philanthropy,eg ,informed consent is desired by the receipt of care as needed for intelligent decision making in keeping with goals and values of the receipt care and in acknowledge of the right of self determination.Informed concent is seen by provider of care as desirable as a means of protection against charges of coercion or any other charges that would hold the provider liable for the outcomes of the services rendered.

3.CONVENANT MODEL

The convenant model includes and includes and extends beyond that of code and contract.it include aspects of code: fidelity to duty, responsibilities to patients and colleagues.It includes elements of the contract model in terms of fidelity to the terms of a contract.

Advantages of convenant model is

Permits possibility of self-discipline

Not so personal applies to the whole profession,a convenant with society boardens accountability.

Permits setting professional responsibility for one human good within social limits.

Relationship between the provider and receipent;

If the physician self conception is as parentor priest ,then the patient is seen as dependent.

If the physician self conception is an techincian ,then the Patient is seen as passive host of the disease.

If the physicians self conception is as contractual partner ,then the patient is seen as equal participant.

If the physicians self conception is as convenantor ,then the patient is seen as active participant and is there are with all other parties,providers and gifts and debts ,promises and obligations.

Now consider the application of the models and images to the three cases offered at the start of this module .Inso doing you should see fairly clearly the rather different results that might emerge inthe same solution but using a different conceptual setting,a different model for examining the nature of the relationship and whatever obligations may be involved.