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Abstract

Editor's note: This paper was read at the eighth annual University of Dayton Philosophy Colloquium, held in 1979.

This paper will attempt to examine the various facets of the notion of responsibility as it applies to the interactions involving health care. Three parties can be identified in these interactions and their responsibilities are frequently interwoven to the point that it makes little sense to talk of one without the others. Of these three parties, two are generally individuals while the third is frequently designed as an abstract collective. The first party we can identify as the patient, the individual who receives the health care. Ordinarily, this is a single person in need of therapeutic relief, although at times a limited group might be considered to be the patient. For example, a husband and wife in conjoint physiological or psychological distress may be considered as a patient-unit. Or whole families may likewise be considered a patient-unit. The second party in the health care interaction is generally designated as the physician or his/her surrogate. The party may at times involve a team of individuals but with all having the same sort of responsibilities toward the patient. Included as another example of this sort of party would be a hospital or any other health care facility with whom the patient has entered into agreement for care. The final (third) party involved in health care interaction is the health care profession in general. I am not here referring to a structured professional organization such as the American Medical Association. I am here referring to that informal grouping that we abstractly call "The Profession." While it is not empirical in any sense, as the first two parties are, nonetheless, it has a profound influence upon the quality of health care available to the population. In ways that are more or less informal, it imposes standards on the practitioners of the medical arts, and these in turn react to those standards in certain ways. In recent years we find these standards becoming more formalized but only because there was some sense of profession that antedated such formal codes.

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