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See id. at 2409. Dougherty seems to miss the central focus of Judeo-Christian religious tradition, namely, God. From this tradition individuals have worth because they are created in the image of God and to have communion with God.Google Scholar

The term “worldview” will be taken to mean those values and beliefs that shape a physician's approach to moral and ethical concerns. Therefore, what a physician believes concerning God, human nature, and human community would establish how he or she might feel about abortion, euthanasia and many other moral issues.Google Scholar

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Rawls, , Political Liberalism, supra note 12, at 22–28. Rawls' two principles of justice are: “a. Each person has an equal claim to a fully adequate scheme of basic rights and liberties, which scheme is compatible with the same scheme for all; and in this scheme the equal political liberties, and only those liberties, are to be guaranteed their fair value, b. Social and economic inequalities are to satisfy two conditions: First, they are to be attached to positions and offices open to all under conditions of fair equality of opportunity; and second, they are to be to the greatest benefit of the least advantaged members of society.” (Rawls, Political Liberalism, supra note 12 at 5–6).”Google Scholar

Rawls probably would not agree with our depiction of his view, for he considers his theory of justice to be deontological and not utilitarian or egoistic. He writes in one place that his principles of justice, like Immanuel Kant's, are categorical imperatives. (Rawls, , Theory of Justice, supra note 12, at 253). However, some scholars, such as: Sandel (supra note 2); Galston, W.A., Liberal Purposes (New York: Cambridge, 1991), Emanuel, E. (The Ends of Life (Cambridge, MA: Harvard University Press, 1991; Moreland, J.P., “Rawls and the Kantian Interpretation,” Simon Greenleaf Review of Law and Religion 8 (1988-89): 27–55); and Pavlischek, K., John Courtney Murray and the Dilemma of Religious Toleration (Kirksville, MO: Thomas Jefferson University Press, 1994): At 208–212, have made assessments of Rawls' theory which are similar to ours.Google Scholar

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See id., at 195–211. There are those to Rawls' political right, such as secular libertarians, who espouse state “neutrality” when it comes to questions of “the good.” For example, libertarian social philosopher Murrary Rothbard writes: “[W]hile the behavior of plants and at least the lower animals is determined by their biological nature or perhaps by their ‘instincts,’ the nature of man is such that each individual person must, in order to act, choose his own ends and employ his own means in order to attain them. Possessing no automatic instincts, each man must learn about himself and the world, use his mind to select values, learn about cause and effect, and act purposively to maintain himself and advance his life. … Since each individual must think, learn, value, and choose his or her ends and means in order to survive and flourish, the right of self-ownership gives man the right to perform these vital activities without being hampered and restricted by coercive molestation.” (emphasis added) (Rothbard, M. N., For a New Liberty: The Libertarian Manifesto, rev. ed. (San Francisco: Fox & Wilkes, 1978): At 28,29).Google Scholar

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See, for example, Beckwith, F.J., Politically Correct Death: Answering the Argumens for Abortion Rights (Grand Rapids, MI: Baker, 1993); Lee, P., Abortion and Unborn Human Life (Washington DC: The Catholic University of America Press, 1996); Mitchell, J.A. Rae, S.B., “The Moral Status of Fetuses and Embryos,” in Stetson, B., ed., The Silent Subject: Reflections on the Unborn in American Culture (Wesport, CT: Greenwood, 1996): 19–32; George, R.P. Bradley, G.V., “Marriage and the Liberal Imagination,” Georgetown law Journal 84 (1995): 301–320; Coolidge, D.O., Same Sex Marriage?, Crossroads Monograph Series in Faith and Public Policy, vol. no. 9 (Wynnewood, PA: Crossroads, 1996); and Moreland, J.P. Rae, S.B., Body and Soul (Downers Grove, IL: InterVarsity Press, 2000)Google Scholar

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At least the effect of social values has a powerful impact on clinical practice. For example, “a surprising 85 percent of everyday medical treatments have never been scientifically validated.” Millenson, M. L., Demanding Medical Excellence (Chicago, Ill: The University of Chicago Press, 1997): At 4.Google Scholar

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Osler, supra note 38, at 93. It may not have been Osler's intention to help establish PVN as a dominante belief for patient-physician interactions. However, his work has helped foster PVN.Google Scholar

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We believe this description was coined by Notre Dame law professor G.V. Bradley in his article, “Shall We Ratify the New Constitution?: The Judicial Manifesto in Casey and Lee,” in Eastland, T., ed., Benchmarks: Great Constitutional Controversies in the Supreme Court, (Washington, DC: Ethics & Public Policy Center / Grand Rapids, MI: Eerdmans, 1995): 117–140, at 123.Google Scholar

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Not only religious and political values, in a general sense, are considered inappropriate, according to PVN proponents, but also specific positions on certain issues. For example, the American Medical Association favors a prochoice position on abortion, a position proposed as appropriate for the profession. (See Council on Ethical and Judicial Affairs, American Medical Association, Code of Medical Ethics: Current Opinions and Annotations [Chicago, IL: American Medical Association, 1997]: At 3). Yet, abortion is a controversial issue over which there is reasonable disagreement among well-meaning people. See, for example, the anthology edited by Pojman and Beckwith, supra note 48.Google Scholar

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Id., 302. Planned Parenthood v. Casey, supra note 50, in contrast to earlier U.S. Supreme Court decisions (see City of Akron v. Akron Center for Reproductive Health, Inc., 462 U.S. 416 [1983] and Thornburgh v. American College of Obstetricians and Gynecologists, 476 U.S. 747 [1986]), allowed states greater freedom in passing informed consent laws that are intended to discourage pregnany termination. The Court, both in Akron and Thornburgh, struck down such laws as unconstitutional.Google Scholar

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This is a distinction drawn by J.A. Shelly in her book with Miller, A.B., Values in Conflict, (Downers Grove, Ill: InterVarsity Press, 1991).Google Scholar

Of course not all members of a profession would have to agree on a given set of values. A majority, however, would embrace the set of professional values and “profess” them as appropriate behavior for members of that profession.Google Scholar

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Interestingly, some have argued that if patients were to smoke and drink more a tremendous amount of health care dollars could be saved. See, Wright, V.B., “Will Quitting Smoking help Medicare Solve its Financial Problems?” Inquiry 23, (1986): 76–82; and Leutwyler K., “The Price of Prevention,” Scientific American (April, 1995): 124–129.Google Scholar

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Expressions of empathy, compassion, care, or sympathy are all extremely value laden. Removing values from the patient physician relationship seems of necessity to remove empathy and the like from the patient physician relationship. See, Peppin, J.F., “What is the Relationship between Physician Values and Physician Value Neutrality: A Christian Perspective,” in Kilner, J. Cameron, N. Schiedermayer, D., eds., Bioethics and the Future of Medicine: A Christian Appraisal (Grand Rapids MI: Eerdmans, 1995): 37–49. Although beyond the realm of this paper, it is interesting to speculate on studies correlating the lack of empathy with aggressive or antisocial behavior. See, Miller P.A. Eisenberg N., “The Relation of Empathy to Aggressive and Externalizing/Antisocial Behavior,” Psychological Bulletin 103, no. 3 (1988): 324–344.Google Scholar

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