The title of Tom Wolfe's current best seller, The Right Stuff, refers to those qualities — manliness, fearlessness, survivability, and recklessness — that characterize successful test pilots in general, and Mercury astronauts in particular. A similar list could be compiled to characterize successful surgeons. It would likely include decisiveness, confidence, dexterity, and dedication. The list would be unlikely to include open-mindedness or a concern to present patients with all the options available for particular disease conditions.

This “self-righteous silence” has recently brought the wrath of the women's movement down on surgeons who perform breast cancer operations without informing their patients about alternatives. And in 1979 Massachusetts became the first state to enact a law requiring physicians to provide “a patient suffering from any form of breast cancer” with “complete information on all alternative treatments which are medically viable.” This column examines the reaction to the law.