Chapter 1: Introduction

1.1.Background

1.2.Identifying the doctor and the patient in health service delivery

1.3.When does a doctor-patient relationship come into being?

1.4.Aim and methodology

1.5.Research question and underlying assumptions

1.6.Outline of study

1.6.1.Chapter 2

1.6.2.Chapter 3

1.6.3.Chapter 4

1.6.4.Chapter 5

1.6.5.Chapter 6

1.6.6.Chapter 7

1.6.7.Chapter 8

PART A

Chapter 2: The historical development of the doctor-patient relationship and the culture of medical care

2.1.The historical development of the doctor-patient relationship

2.1.1.Primitive society

2.1.2.The Greek medical tradition （± 600- 100 B.C.）

2.1.3.Classical, medieval and early modern societies （1200-1600A.D.）

2.1.4.Modern western societies （1700-1900A.D.）

2.1.5.Postmodern societies

2.2.The culture of medical care

2.2.1.Professionalism and the regulation of the medical profession

2.2.2.Social roles and the doctor-patient relationship

2.2.2.1.The physi?an’s role

2.2.2.2.The sick role

2.2.3.Professionalism, authority and the doctor-patient relationship

2.2.4.Power and the doctor-patient relationship

2.3.Conclusion

Chapter 3: Medical decision-making and the doctor-patient relationship in a paternalistic setting

3.1.Defining medical paternalism

3.2.Medical decision-making in a paternalistic medical setting

3.3.Autonomy, dignity, self-determination and beneficence in medical decision-making

3.4.Ajuridical response to traditional paternalism in medical decision-making

3.4.1.Informed consent

3.4.1.1.The origin of informed consent

3.4.1.2.The development of the doctrine of informed consent

3.4.1.3.The current status of the doctrine of informed consent

3.5.An evaluation of medical decision-making and the doctor-patient relationship

3.5.1.Standards of disclosure

3.5.2.Historical attributes

3.5.3.Practical considerations

3.5.4.The efficiency of the doctrine of informed consent

3.5.5.Recommendations

3.6.Conclusion

PART B

Chapter 4:The doctor-patient relationship in the medical marketplace

4.1.Definingthe business model in medical practice

4.2.The relevanoe of the business model to medical practice and the doctor-patient relationship

4.3.The business model and the power imbalances in the doctor-patient relationship

4.3.1.Informed consent

4.3.2.Patients’ rights, patient autonomy and the defiance of benefioence

4.3.3.The erosion of trust in the doctor-patient relationship

4.4.Conclusion

Chapter5: The fiduciary nature of the doctor-patient relationship

5.1.The doctor-patient relationship as a fiduciary relationship

5.2.The legal content of the fiduciary relationship between doctor and patient

5.3.The doctor as a fiduciary in the doctor-patient relationship

5.3.1.The duty of loyalty

5.3.2.The duty to act in the patient’s best interest

5.4.The patient as a beneficiary in the doctor-patient relationship

5.4.1.Right ore ntitlement to a benefit enforceable against the fiduciary

5.5.An evaluation of the doctor-patient relationship as a fiduciary lationship

5.6.Conclusion

PART C

Chapter 6: The doctor-patient relationship in an era of managed care

6.1.The history and development of managed care in health service delivery

6.2.The influence of managed care practices on the doctor-patient relationship

6.2.1.Access to health care

6.2.2.The new role of the physician in the doctor-patient relationship

6.2.3.Trust in the doctor-patient relationship and trust in managed care institutions

6.2.4.Informed consent in an era of managed care

6.2.5.Patient advocacy in an era of managed care

6.3.Conclusion

Chapter 7: Consumerism and the doctor-patient relationship

7.1.Consumer choice, patient autonomy and the ethical limits of consumer responsibility

7.2.Consumer protection in the doctor-patient relationship

7.3.Consumer empowerment and the doctor-patient relationship

7.4.Conclusion

Chapter 8: A proposed re-conceptualisation of the doctor-patient relationship to redress power imbalances

8.1.Are there power imbalances in the doctor-patient relationship?

8.2.Can the doctor-patient relationship be re-conceptualised, from a legal perspective, to redress the power imbalances inherent in the relationship?

8.2.1.The role of autonomy, dignity, self-determination and benefioence in the doctor-patient relationship

8.2.2.The doctrine of informed consent and the power imbalances in the doctor-patient relationship

8.2.3.The fiduciary nature of the doctor-patient relationship and the power imbalances inherent in the relationship

8.2.4.The role of trust in the doctor-patient relationship

8.3.Concluding remarks

Table of cases

Bibliography

Index