Citation

Benatar SR, Upshur RE. Am. J. Public Health 2008; 98(12): 2161-2167.

Affiliation

University of Cape Town - Department of Medicine - Bioethics Centre.

Copyright

(Copyright © 2008, American Public Health Association)

DOI

10.2105/AJPH.2007.124644

PMID

18923128

PMCID

PMC2636540

Abstract

The concept of the dual loyalty physicians may have to both a patient and a third party is important in elucidating the obligations of physicians. The extent to which loyalty may be deflected from a patient to a third party (e.g.,an insurance company or a prison commander) is greatly underestimated and has not attracted significant scholarly analysis. We examined dual loyalty in civilian and military contexts and used the principles of public health ethics to construct a framework for determining the legitimacy of physicians' obligations. We illustrate the application of these principles to problems physicians encounter regarding communicable diseases, elder abuse, and driving fitness. In the complex military context, independent ethics tribunals should be created to adjudicate loyalty conflicts.

Language: en