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"The fixed person for fixed duties, who in older societies was such
a godsend, in the future ill be a public danger." Twenty years ago,
a single legal metaphor accurately captured the role that American
society accorded to physicians. The physician was "c- tain of the
ship." Physicians were in charge of the clinic, the Operating room,
and the health care team, responsible - and held accountabl- for
all that happened within the scope of their supervision. This grant
of responsibility carried with it a corresponding grant of
authority; like the ship's captain, the physician was answerable to
no one regarding the practice of his art. However compelling the
metaphor, few would disagree that the mandate accorded to the
medical profession by society is changing. As a result of pressures
from a number of diverse directions - including technological
advances, the development of new health professionals, changes in
health care financing and delivery, the recent emphasis on consumer
choice and patients' rights - what our society expects phy- cians
to do and to be is different now. The purpose of this volume is to
examine and evaluate the conceptual foundations and the moral imp-
cations of that difference. Each of the twelve essays of this
volume assesses the current and future validity of the "captain of
the ship" metaphor from a different perspective. The essays are
grouped into four sections. In Section I, Russell Maulitz explores
the physician's role historically.
"The fixed person for fixed duties, who in older societies was such
a godsend, in the future ill be a public danger." Twenty years ago,
a single legal metaphor accurately captured the role that American
society accorded to physicians. The physician was "c- tain of the
ship." Physicians were in charge of the clinic, the Operating room,
and the health care team, responsible - and held accountabl- for
all that happened within the scope of their supervision. This grant
of responsibility carried with it a corresponding grant of
authority; like the ship's captain, the physician was answerable to
no one regarding the practice of his art. However compelling the
metaphor, few would disagree that the mandate accorded to the
medical profession by society is changing. As a result of pressures
from a number of diverse directions - including technological
advances, the development of new health professionals, changes in
health care financing and delivery, the recent emphasis on consumer
choice and patients' rights - what our society expects phy- cians
to do and to be is different now. The purpose of this volume is to
examine and evaluate the conceptual foundations and the moral imp-
cations of that difference. Each of the twelve essays of this
volume assesses the current and future validity of the "captain of
the ship" metaphor from a different perspective. The essays are
grouped into four sections. In Section I, Russell Maulitz explores
the physician's role historically.
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