A Covenant of Trust

By Bill Moreau, DC, DACBSP, CSCS

Healthcare is a special kind of human activity involving a moral endeavor that is grounded in a pledge or covenant of trust. The tradition and the very nature of healthcare is one that cannot be pursued effectively without the virtues of modesty, honesty, intellectual truthfulness, empathy, and the removal of unwarranted self-interest. Society recognizes these traits as the valued characteristics that mark doctors as members of an ethical community dedicated to doing something other than promoting their own self-interests. This covenant obliges the doctor to be competent and to use our competence in the patient’s best interests. Health care providers are intellectually and morally obliged to act as advocates for the sick and injured who present to us. The agreement is that we will always place the patient’s best interests in the highest regard and that we will protect and defend the welfare of our patients.

Today, this covenant of trust between doctors and patients is significantly threatened. There are a plethora of practitioners and practice building organizations devoted to developing patient dependence on the doctor. Some are devoted to primary principle of financial gain at almost any cost, which leads to the erosion of the sanctity of the doctor patient relationship. When a doctor yields to the temptation of placing their own financial needs first this changes the trust relationship with the patients. Giving in to financial need and greed also changes the doctor’s role as healer, helper, and advocate for the patient.

Our first obligation must be to serve the good of those persons who seek our help and trust us to provide it. We must be patient centered, not doctor centered. Any deflection from the priority of placing first our patient’s well being first places the patient at risk. Only by providing truly caring services and by becoming an honest advocate for our patient can the integrity of our profession be affirmed. Honoring our doctor patient covenant is also how we expand the public’s trust for our profession.

REF: Special Feature – Medical Ethics Commentary, Doctor-Patient Relationship: a Covenant of Trust, JJ Chin, Singapore Med J 2001 Vol 42(12) : 579-581