Ethics in Diagnosis: Bodily Integrity, Trust-Telling, and the Good Physician

Abstract

In addition to the acquisition of differential knowledge on the part of a physician, medical diagnosis depends on the subtleties of the patient-physician encounter, the prevailing nosological and conceptual systems in which this encounter occurs, the current status of biomedical research, and the physician’s reliance on the accuracy, reliability, and validity of the available laboratory analyses. Indeed, one can also make the case that the process of medical diagnosis tacitly involves the normative presuppositions of the medical context, the uncertainties of questionable diagnoses that may lead to ill-effects (including the physician’s failure to obtain peer and family approval rooted in a lack of confidence in his or her diagnostic competence), the values of other health care practitioners involved in a patient’s case, the diagnostic modalities available in the clinical setting in which specific medical acts take place, and even postmortem procedures [8] (when no treatment is possible) as propaedeutic to future diagnoses that are often forgotten but critical to public health problems like today’s AIDS epidemic.

I am very grateful to Tom Bole III, Ph. D., Richard J. Castriotta, M.D., Roger Crisp, D. Phil., Eric T. Juengst, Ph.D., Julius Landwirth, M.D., Ian R. Lawson, M.D., and Robert U. Massey, M.D., for their time and interest in as well as for their suggestions and constructive criticisms of the initial manuscript; the remaining misexplications are, of course, entirely mine.