Medicine, Law and the Public Interest

The underlying rationale of medical law has undergone radical shifts in the brief lifespan of the discipline. Historically, the law as it related to the practice of medicine has been a muted affair. Judges, and therefore the law, have tended to defer to the medical profession and much of the substance of the law has supported medical paternalism. A revolution has occured more recently, however, with the rise in importance of the principle of respect for patient autonomy. This has concentrated the focus of the law on the need for a patient's informed consent across a range of circumstances including treatment, research, and all decisions relating to health and health care. Paternalism now receives very short shrift. But this volte face has moved the discipline to an opposite extreme where the patient's wishes often assume paramountcy. This polarization of the values driving and informing medical law - from professional paternalism to individual patient choice - ignores broader, deeper values which, while underpinning medical law, are often overlooked. These are communitarian values, and they are often expressed in terms of the public interest. This book takes a critical look at the phenomenon and impact of patient autonomy in medical law and offers an alternatve perspective on the nature of the discipline by examining the difficult and complex interface between patients' rights and the public interest.