Allergic to Paternalism


My husband is a Certified Financial Planner®, and he’s an expert in helping people manage their money. One of his biggest frustrations is clients who think they know what they need, reject his advice, then blame him for the poor performance of their portfolios. We can do the same thing to our doctors.

When we get sick, we can show up at the doctor’s office, armed with information we gleaned from the internet. This is not all bad. It is good to play an active role in managing our health. But what does that role look like?

In an age of rampant entitlement and consumerism, it is easy to see medicine as just another service we buy, paid for by insurance companies, Medicaid or Medicare. When we see ourselves as the customer, we put our doctor in the role of a service provider. In this context, we can resent being told what to do; we may shop around for a better opinion; and we treat medical advice as just a suggestion. In essence, we act like we’re the ones in charge.

This is not how Christians have historically viewed the doctor-patient relationship. The history of that understanding dates back to Ancient Greece and the Hippocratic Oath. This vow traditionally taken by physicians was grounded in the idea of covenant . . . a word that has particular resonance for Christians. The covenant between a doctor and his patient includes the physician’s commitment to “first, do no harm.” This is expected in a relationship requiring integrity and trust. In other words, a doctor is more than a service provider.

But in order for this covenant view of the doctor/patient relationship to work in practice, patients must accept the loving care of a committed, qualified physician. In our culture, it’s hard to follow any kind of authority. Yes, there have been abuses, when no one questioned the doctor’s authority. But the pendulum has swung to the opposite side. We have become “allergic” to medical paternalism, even if our doctor is a woman. But as patients, we should humbly acknowledge that while medical professionals are not infallible, they are experts. They have undergone years of education and training to become expert in diagnosing diseases and caring for their patients. We should listen carefully and respectfully to their advice, and we should entrust ourselves to their care.

This doesn’t mean that we should never seek a second opinion or challenge the direction of care suggested by our physicians. And granted, all physicians don’t approach their patients with covenantal responsibilities in mind. Indeed there are many patients who have been treated wrongly or have experienced abuse at the hands of doctors. But in the typical situation, our attitude as patients should be one of humility and trust, honoring the special calling God has given our doctors. Our respect may in turn help them to practice in the best of their tradition.


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