The contractual model of the patient-physician relationship assumes that doctors boast exclusive access to medical facts, while patients have access to personal values as well as preferences. It definitely justifies unfettered patient autonomy in medical decision-making. This complete separation of the fact-value dichotomy has had the unfortunate outcome of contributing to the commercialization of up-to-date medicine, where doctors are considered to be service providers, while patients respectively act as pure consumers shopping for medical goods. As follows from this, the PPR turns to be a sort of business or contractual relationship. In today’s libertarian society, contractual relationships actually cover a wide array of human transactions as well as interactions, where equal parties agree freely and voluntarily, just like autonomous agents on certain undertakings with specific purposes, interests and objectives in mind.
In private medical practice where doctors are used to retaining more control over the type, location, scope as well as conditions of practice, the contractual nature of the PPR is quite visible. However, even in a non-private setting, suggesting no specific agreement in place, by convention, whenever a doctor undertakes to treat a patient, she or he is held in law to have implicitly contracted with the sick person, and the physician’s subsequent conduct is fully governed by the implied contract in oder to render care in compliance with certain pre-established standards. Hence, common law normally assumes the contractual model exactly as the starting point for analysis of tort duties in a PPR,5. In fact, the given approach has several advantages.
Firstly, by simply infusing a strong sense of symmetry, equality and mutuality into the PPR, the contractual model fully undermines the traditionally more authoritarian models. Secondly, since a contract is powered by the interests and objectives of the contracting parties, and every party makes use of the contract to his or her own ends as well as advantages, it gets ride of the overbearing element of philanthropy or condescension of charity usually displayed by doctors in a PPR. Additionally, by providing or referring to explicit contractual terms, which are legally enforceable, the model ensures formal protection for parties within a PPR. However, a contractual PPR features far more vices than virtues.
The contractual model appears to be inadequate enough to illustrate the complexities of the patient-physician relationship. The model is complex because doctors and patients aren’t contracted as conventional sellers and buyers.
The contractual model of the patient-physician relationship assumes that doctors boast exclusive access to medical facts, while patients have access to personal values as well as preferences. It definitely justifies unfettered patient autonomy in medical decision-making.