Intended for healthcare professionals

Editorials Christmas 2014: Editorials

Imbalance of power between patients and doctors

BMJ 2014; 349 doi: (Published 15 December 2014) Cite this as: BMJ 2014;349:g7485
  1. Christian Koeck, professor
  1. 1HCC Health Care Company, Schottengasse 4, 1010 Vienna, Austria
  1. ckoeck{at}

The price of ignoring the shadow

The human capacity to understand the world is truly astonishing. What began with a taste of the fruit from the “tree of good and evil,” has developed into our unlimited capacity to separate, differentiate, define, and analyse. Consequently, the natural sciences have handed humanity previously unimaginable powers to control and shape the world. In the words of Susan Sontag, we have expanded the boundaries of the kingdom of the well and gained control of significant parts of the kingdom of the sick.1

To make this possible, society has provided vast resources to the medical sector and given physicians powers no other profession has: to open the human body, to prescribe potentially lethal substances, and to cut, pierce, and replace organs and body parts. With great powers come great responsibilities and fears. In the “Role of fear in overdiagnosis and overtreatment,” Iona Heath eloquently described the everyday inner conflicts of patients and doctors. …

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