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Edmund D. Pellegrino, MD
Kennedy Institute of Ethics Georgetown University Washington, DC

JAMA. 1988;259(4):517-518.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In Reply.

—I am pleased that Dr Tiemstra found some points of agreement with my editorial. I am sorry he missed the major thrust of my argument.

Dr Tiemstra draws the erroneous inference that I favor paternalism because I emphasize the dependence, vulnerability, and exploitability of the sick person. Rather, I hold that those features of illness impose the obligation to enhance the autonomy of the patient.¹

Dr Tiemstra denies that there is something special about being ill and being healed. He ignores the special nature of the invasion of personal privacy that a medical education entails. He equates access to a knowledge of pipes and drains, or to various business procedures, with access to knowledge of a person's body, emotional history, or state of suffering.

The comment about student selection is gratuitous. However students are selected, once admitted they are morally bound to observe the obligations of being . . . [Full Text PDF of this Article]

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