LETTER
Nonabandonment: Medical Ethics
John R. Lindquist, MD
15 September 1995 | Volume 123 Issue 6 | Page 473
TO THE EDITOR:
In their recent paper, Quill and Cassel [1] emphasized that nonabandonment was a necessary component of the physician-patient relationship. In an accompanying editorial, Dr. Pellegrino [2] discussed and refuted the issue of elevating this concept to the status of an ethical principle.
I believe that both papers neglected time and responsibility as more important variables meriting further discussion. The physician-patient relationship is by nature longitudinal and potentially vulnerable in this evolving managed care era. Patients seem to acknowledge this more than physicians do, and the choice of physicians seems to remain a non-negotiable item in health care reform. Perhaps time spent in medical residencies, not just medical school, learning how to effectively communicate with patients (rather than with increasingly sophisticated computers) would also be time well spent.
Responsibility is a more fundamental component of the physician-patient relationship that, in fact, also encompasses non-abandonment. Others have characterized the legal, moral, social, and cultural dimensions of responsibility [3], but we must not lose sight of the fact that the physician's primary responsibility to the patient is accurate diagnosis and precise therapy. As medical educators, it is our responsibility to ensure this and direct our efforts appropriately.
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Author and Article Information
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Glenbrook Hospital; Glenview, IL 60025
1. Quill TE, Cassel CK. Nonabandonment: a central obligation for physicians. Ann Intern Med. 1995; 122:368-74.
2. Pellegrino ED. Nonabandonment: an old obligation revisited [Editorial]. Ann Intern Med. 1995; 122:377-8.
3. Agich GJ, Youngner SJ. For experts only? Access to hospital ethics committees. Hastings Cen Rep. 1991; 21:17-24.
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