Ep. 76 Defenders of the Status Quo: Arthur Caplan and the Modern Bioethics Movement

Michel Accad, MD

A short episode commenting on a recent piece in Medscape by Arthur L. Caplan, one of the most influential bioethicists of the last 40 years.  


Arthur Caplan.  “No, Patients Are NOT Consumers, and MDs Are NOT Providers,” Commentary in Medscape, April 2019

Tom Koch. Thieves of Virtue MIT Press 2012


Episode 50. Thieves of Virtue: How Bioethics Stole Medicine (with guest Tom Koch)


  1. Lysander Spooner on 05/03/2019 at 8:58 PM

    Caplan’s argument seems to be the classic “this is a special case”. No, it’s not. Medicine is a service like any other in all the important ways.

    For example, people seeking legal advice are often just as vulnerable and ignorant as those seeking medical care.

    Patients & medical services providers (some of whom are doctors) should be freed of the shackles imposed by the coercive hands of the people calling themselves the government.

  2. Anthony M. Perry,MD on 05/05/2019 at 11:55 PM

    What else is a patient but a consumer of medical goods and services. What else is a physician than a provider of those services.

    In a free society, where people are not slaves or serfs, they weigh options and choose based their means and preferences. In our third party payment system where the economic price is often low or negligible they often choose in accordance with the price accepting recommendations or requesting items which they would not at a different price. But where there is discomfort or risk involved in medical options such considerations often predominate and they choose based on what they consider to be their self-interest.

    As far as incomplete knowledge is concerned, consumers choose items all the time with incomplete knowledge and frequently very consequential and high priced services such as housing, transportation and as mentioned by another commenter, legal services. Consumers make such choices, for the most part satisfactorily, based on their degree of knowledge, past experience, recommendations of friends and family, general reputation of providers, recommendations of various certifying agents and media evaluations, and most importantly recommendations of advisors whom they have come to trust.

    Medical services are somewhat unique in that we feel sympathy for those who have physical misfortune or are lacking in financial resources and feel such persons should be provided for. Medical providers to a high degree must have compassion for those they serve and conduct themselves ethically. But we also expect and demand ethical practice from providers of most other services.

    Those who do not understand the consumer role in our free society and wish to mandate government control and elimination of price considerations do far more harm than good for the well being of those they purport to serve.

  3. David C. Norris, MD on 05/09/2019 at 12:27 AM

    A wonderful demolition of exactly the same type of “duplicity” I have encountered myself in recently from the ethicists. I agree their defining feature is to have placed themselves at the service of the administrative state, at the expense of the individual person—and, epistemically, in service of what Janet Woodcock has called “nihilistic empiricis[m]” at the expense of scientific progress.

    For those with access, here’s a link to a Twitter exchange around my Letter published recently online in JAMA Pediatrics: https://twitter.com/davidcnorrismd/status/1120402435430854656.

  4. […] 19-minute monologue from Dr Michel Accad is here(it’s part of the often-thought-provoking podcast, The Accad and Koka […]

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