Patient, Heal Thyself: How the "New Medicine" Puts the Patient in Charge

by Robert M. Veatch

Robert Veatch is one of the founding fathers of contemporary bioethics. In Patient, Heal Thyself , he sheds light on a fundamental change sweeping through the American health care system, a change that puts the patient in charge of treatment to an unprecedented extent. The change is in how we think about medical decision-making. Whereas medicine's core idea was that medical decisions should be based on the hard facts of science--the province of the doctor--the "new medicine" contends that medical decisions impose value judgments. Since physicians are not trained to make value judgments, the pendulum has swung greatly toward the patient in making decisions about their treatment. Veatch shows how this is presently true only for value-loaded interventions (abortion, euthanasia, genetics) but is coming to be true for almost every routine procedure in medicine--everything from setting broken arms to choosing drugs for cholesterol. Veatch uses a range of fascinating examples to
reveal how values underlie almost all medical procedures and to argue that this change is inevitable and a positive trend for patients.

287 pages, Hardcover

First published November 4, 2008

Reviews

[Leslie · Rating 4 out of 5]

Veatch is highly iconoclastic. In fact, at times the book lulled me into thinking he was being satirical--I was waiting for him to add that we should eat the excess babies when I realized he was being perfectly serious. His ideas have merit; the recognition that all decisions we make in medicine are heavily value-laden is important. However, his philosophy also seems reactionary. It is the pendulum swinging from paternalism to unrestricted libertarianism. As such, it denies the value and moral agency of medical providers' knowledge and standing as human beings, respectively. There must be a middle ground, with a sound ethical norm, couched in a reasonable set of "know-able" concepts, that does not require an impossibly administratively complex revamping of the medical system or an impossibly chaotically individualized standard of communication among patients and providers. Among the concepts not introduced in the book, but probably worthy of exploration, is the role that basic health literacy should play in the establishment of transparent norms for understanding medical biases towards being interventionist and for respecting both agents in communication.

Personal note: see notes in "Veatch Basics of Bioethics."

[Marcela · Rating 3 out of 5]

Doctor doesn't always know best, doesn't necessarily share values of patients. Started off liking the message of the book since I've been reading a lot about participatory medicine. As the book progressed, felt like he went too far saying that doctors shouldn't be writing prescriptions and some tangent about calling people fat vs overweight.