Farewell Professional Dominance
Rob Irvine2007, Metascience
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Abstract
is perhaps best known to readers as a scholarpractitioner with an avowed commitment to humanist medicine. This work follows on from an earlier volume, Confessions of a Medical Man (1999), which was primarily concerned with metaphysical questions. His latest book contributes to an ongoing interrogation of the nature of ethics in medical practice and suggests new lines of thought and inquiry. The book begins with a brief overview of the doctor-patient relationship as it has unfolded historically under a variety of social, political, and economic conditions. In response to the question, ÔWhat is wrong with modern medicine?' Tauber argues that the most pressing problem is the instantiation of a different moral tone than has traditionally governed medical practice: at the bedside and in the clinic, disillusionment and mistrust have become dominant dispositions that cut into patients and practitioners everywhere. The sources of breakdown in the doctor-patient relationship that are cited are very familiar: Tauber's account of medical practice concerns a healthcare system dominated by commodification, corporatisation, and the market. Modern healthcare institutions have been remade to resemble ''something like a glorified buttons factory'' (p. 3) and are no longer ethical, he declares. The broad malaise that has overtaken social relations and moral life has deepened for other reasons. There is a good deal of discussion about medicine's failure to acknowledge and understand the patient's lived social and psychological experiences of illness. Nor is medicine admired for its grasp of the way patients make medical decisions. Prominent among the philosophical themes in the history
