Physicians and philosophers have contributed to the field of medical ethics several different paradigms for the physician-patient relationship. Here I suggest another: marriage. Patients usually enter into relationships as we enter marriage: we allow our high hopes to obscure the possibility of deep disappointment. The argument of the essay encourages renewed focus on the contractual element of physician-patient relationships.
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John Portmann, PhD, (MPhil CANTAB), is Executive Assistant to the Provost at the University of Virginia, Charlottesville, USA.