The Evolution of Medical Ethics & Patient Experience

Jan 5, 2017

A visit to the doctor’s office can sometimes be an uncomfortable experience - both physically and psychologically. 

Dr. Barron Lerner knows this all too well. Lerner is a medical doctor, and a professor of medicine and population health at New York University. He's also an author and commentator on medical ethics, which his most recent book deals with in-depth. The Good Doctor: A Father, A Son, and the Evolution of Medical Ethics, is both a look at the history of bioethics and a reflection on his own career as a physician. 

"The beginning of the field in the 1970s and 80s reflected a bunch of scandals, and medicine the way it was practiced before that time had to change. Doctors had too much power, researchers were taking advantage of human subjects and there had to really be a sea-change," Lerner explains. 

Dr. Lerner believes that medical ethics and the patient experience are an integral part of a physicians work, and should be treated like any other issue that comes up in a medical setting. 

"I like to think of ethical problems as something like a heart problem or a lung problem. As you're training, you need to get the knowledge and skills," he says. "Just like you need to read an electrocardiogram you should know the basics of the ethical issues.

"A patient, for example, is refusing a procedure that you think is necessary. Or a patient is using hospital resources in a way that doesn't seem fair to other patients," he continues. "Those sorts of things; you at least have a familiarity with them and then you try to use the skills that you've acquired along the way to solve that." 

Lerner stirred up controversy with a piece in the New York Times last August, which discussed a law in Florida that restricts a physician's ability to ask patients about gun ownership. The piece brought up the bigger issue of what doctors are allowed to talk about with their patients. While he admits there may be some questions that are off-limits (he gives, "Who'd you vote for in the last election?" as an example), he feels strongly that any question that helps a physician advise and treat their patient shouldn't be limited by the government. 

"I think most things are fair game. If you're trying to help somebody and understand their living situation, understand the risks present at their home," says Lerner. "Asking about guns, for example, or asking about psychiatric illnesses or sexual history should be fair game. So it's disconcerting to us when lawmakers tell us what we can and can't do." 

Dr. Barron Lerner was in Milwaukee to speak with students and faculty for the 2016 Medical Humanities lecture at the Medical College of Wisconsin.