Medical Ethics and the Medical Profession
The most extensive study of the impact of bioethics on clinical practice appears in Intensive Care: Medical Ethics and the Medical Profession by sociologist Robert Zussman. Zussman spent more than two years observing and interviewing in the intensive care units of two hospitals. His research suggests both the impact and the limitations of the bioethics movement.
Although cases such as Karen Quinlan’s and Baby Doe’s might suggest that doctors often want to use aggressive treatment despite the objections of patients and families, Zussman found that the reverse is usually the case on intensive care wards. Knowing that most of their patients will die, doctors on these wards often hesitate before beginning aggressive treatment, which might only escalate costs, increase their work as well as their patients’ suffering, and prolong the dying pro- cess. Patients and their relatives, however, often face a sudden and unexpected medical crisis. Unable to believe the situation hopeless, they demand that health care workers “do everything.” In these situations, the doctors Zussman studied expressed allegiance to the principle that families have the right to make decisions regarding treatment. In practice, however, doctors found ways to assert their dis- cretion if not the authority they had in years past.
