BMJ 2001;323:64 ( 14 July )

Editorials

Wanted: a social contract for the practice of medicine

We need to invest in promoting social consensus

The first 150 words of the full text of this article appear below.

The scandal about stored organs¹ is only one recent manifestation of fundamental disagreements about what people expect from medicine. Irreconcilable differences remain between those who think it's kinder not to go into detail when asking permission to remove organs after death and those who think that respect for individuals' autonomy requires that they should be given all information, no matter how distressing. Moreover, in society the balance of such beliefs changes over time. We propose that an independent high level standing commission should be created to determine socially acceptable norms in the NHS and medicine generallyin effect to draw up and maintain a "social contract" between healthcare workers and the community they serve.

There are many areas in which expectations differ over the practice of medicine. Among these are the degree of confidentiality to which doctors should be bound. For example, if an inheritable genetic abnormality in one patient . . . [Full text of this article]

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Rapid Responses:

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consent for treatment/research

Duncan Paterson
bmj.com, 14 Jul 2001 [Full text]

Wanted: acceptable practice determined by the public

Roger M Goss
bmj.com, 17 Jul 2001 [Full text]

Wanted: a social contract for the practice of medicine

Raj Mohindra
bmj.com, 17 Jul 2001 [Full text]

A social contract for doctors!

Darryl Hoffman
bmj.com, 19 Jul 2001 [Full text]

no more quangos

N Sarkies
bmj.com, 20 Jul 2001 [Full text]

A social contract for accountablility

Judith Harvey
bmj.com, 27 Jul 2001 [Full text]

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