One of the defining characteristics of modern society is the medicalization of human life. We are born in hospitals, receive care in hospitals, and meet our deaths in hospitals. It seems that no one questions this state of affairs anymore.
However, the role of the doctor—and the expectations placed upon them—has grown correspondingly. Demands to legalize physician-assisted suicide or euthanasia reveal a tendency to entrust doctors with decisions regarding the very disposition of life. Yet these demands arise alongside calls for respecting the patient's right to self-determination. While it may initially appear that everything is being entrusted to the doctor, the ultimate result is to reduce the doctor to a mere executor of the patient's wishes. Legalizing euthanasia or physician-assisted suicide essentially serves only to absolve doctors of legal liability for such actions.
Consequently, modern medicine is becoming increasingly commercialized; medical professionals are transformed into service providers, while patients become customers receiving those services. It seems that the doctor's own will and judgment are increasingly losing their place.
Of course, this was not always the case. In ancient times, the physician was viewed as someone wielding god-like powers; because they held unilateral authority over the treatment process, the patient's preferences were considered unimportant. This was because the physician alone was deemed to know best what the patient needed and what served their best interests. This attitude is known as "paternalism." However, in modern society, where individual dignity and freedom are highly valued, such a unilateral attitude is not desirable.
In reality, it is difficult for the doctor-patient relationship to be truly equal. Doctors possess far greater knowledge than patients. Yet, simply resolving this imbalance by deferring absolutely to the patient's wishes does not seem appropriate either; for a doctor, that could amount to a highly irresponsible attitude.
Of course, the patient bears ultimate responsibility for their own life and health. However, a patient is, by definition, someone who is ill. They are burdened by the loss of vitality caused by disease, diminished mental clarity, physical pain, anxiety, and a sense of disconnection from others. Under these circumstances, it is difficult to expect a patient—who lacks medical expertise—to make the most beneficial choice on their own.
This is where the doctor is called upon to fulfill multiple roles. They must convey the necessary information regarding the patient's condition and appropriate treatment options, ensuring the patient fully understands them. Furthermore, they must strive to restore the patient's capacity to make sound decisions. And when, in good conscience, a doctor believes a patient is making a decision that could be harmful to themselves, it is necessary to try to persuade them; after all, persuasion is not coercion.
Persuasion is a process of helping the patient come to their own understanding of what constitutes a good choice. Naturally, this process requires the doctor to understand the patient's values. A process that respects the patient's values while guiding them toward choices that serve their life and health allows the doctor to remain faithful to their professional duty without infringing upon the patient's freedom.
In this sense, the doctor-patient relationship can be described as a "therapeutic alliance." An alliance is a contract freely entered into by both parties. Doctors and patients are partners collaborating toward the shared goal of the patient's life and health. Within this relationship, both the doctor and the patient have the right to be respected and protected as individual persons. Medical care is not merely an opportunity to apply medical knowledge; it is an encounter between persons. Within this interpersonal relationship, both doctor and patient move toward fulfillment through communion with God.
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