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June 9, 1989

For the Patient's Good: The Restoration of Beneficence in Health Care

JAMA. 1989;261(22):3314-3315. doi:10.1001/jama.1989.03420220128045

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.


This book is the result of a collaborative effort between a renowned physician and a well-known bioethicist. Their aim in writing the book is made clear early on in the first chapter: "We intend to show... that... acting for the good of the patient and on virtue is more appropriate to the special context of the medical encounter today" (p 3). By "more appropriate" they mean more appropriate than a single-minded allegiance to the principle of autonomy.

The central thesis of this difficult, iconoclastic, and challenging book is that bioethicists (most, according to the authors, under the seductive influence of 19th-century devotees of liberalism such as John Stuart Mill) have gotten physicians hooked on the value of autonomy as the ethical be all and end all of physician-patient relationships. Doctors have somehow gotten it into their heads that their only obligation to their patients consists of discerning what it is