Moral authority, power, and trust in clinical ethics

Moral concerns about the authority, power, and trustworthiness of physician s have become important topics in clinical ethics during the past three dec ades. These concerns have come to greater prominence with the increasing in volvement of large-scale private institutions in the organization and deliv ery of medical services, especially managed care organizations, and with th e increasing involvement of government in the payment for and organization and delivery of medical services. When physicians act as the agents of larg e institutions or,governments, the power of physicians over their patients increases. The purposes of this article are (1) to reflect briefly on the h istorical origins of the moral problem of physicians' power in medicine, an d (2) to introduce the articles in the 1999 annual number of the Journal of Medicine and Philosophy on topics in clinical ethics.