J Med Ethics. 2018 Jun 15. pii: medethics-2017-104682. doi: 10.1136/medethics-2017-104682. [Epub ahead of print]

Conflicting duties and restitution of the trusting relationship.

Eriksen A1,2.

Author information

1

ARENA , Centre for European Studies, University of Oslo, Oslo, Norway.

2

SPS, Centre for the Study of Professions, Oslo and Akershus University College, Oslo, Norway.

Abstract

It is often claimed that medical professionals are subject to conflicting duties in their role morality. Some hold that the overridden duty taints the professional and generates a patient claim to a form of moral compensation. This paper challenges such a 'compensation view' of conflict and argues that it misleadingly makes the role morality into a personal contract between professional and patient. Two competing views are therefore considered. The 'unity view' argues that there are no real conflicts between professional duties. Hence, there can be no residual duties that are impossible to discharge and no special claim on the part of the patient. It is argued that this fails because the institutional nature of the role morality requires us to accept possibility of conflict. The paper articulates and defends a third view, where conflict triggers a professional duty of restitution. This duty is not a matter of making amends for a previous wrong, but rather a matter of rebuilding a trusting relationship that has been damaged due to blameless circumstances.