In this sense, a contract reduces the doctor-patient relationship to a mechanical set of actions, which is also not acceptable in the profession. Nonetheless, much more than the code and philanthropy concepts, the contract elevates the patient to the level of the doctor in terms of mutual need and reciprocity. In the doctor-patient contract, the doctor and patient need each other mutually, and enter into a relationship of exchange. It also enforces accountability, by means of which the patient has legal recourse should something go wrong.

In his conclusion, May suggests that a covenantal relationship that extends not only to the guild, but also to the public, might provide the remedy for the problem of minimilization. He explicates this by means of a comparison between the concepts of the contract and the covenant. The main difference is that the contract is based upon time limitations, while the covenant focuses on building a long-term relationship between the partners involved. While not a perfect solution, doing away with the code of ethics and philanthropy to be replaced by an all-encompassing covenantal relationship, would provide a greater sense of accountability for the relationship of doctors with their patients.

As mentioned above, the author explicates each concepts at length and very clearly. His style of writing is such that it tends to draw agreement from the reader. Indeed, I find myself agreeing with almost all of his concepts. This is not only so because of his seductive style of writing, but also because of the general concept of medical ethics, and the demonstrative episode of the two drug-addicted gynecologists he introduces the chapter with. The medical profession faces many difficulties, including maintaining accountability in an environment where a shortage of doctors often dictates the opposite.

I am not however sure that the code of ethics as explicated in the Hippocratic Oath is as...

The majority of doctors I have been involved with take their code of ethics extremely seriously. Furthermore, I have never felt any sense of condescension from these professionals. I therefore find the author's comparison of condescension with the concept of philanthropy somewhat invalid. This is not however to say that I disbelieve him, or that I believe he is just making a point to substantiate his conclusion. In reading the piece, the author communicates his belief in his concepts and words to the utmost degree, which is why it is initially so difficult to find anything to disagree with.
I do find May's concept of the covenant with the public rather appealing. Indeed, it appears to be the most viable option to deal with the tendency of doctors to be protective within the guild. A covenant would protect the public while ensuring that doctors remain morally accountable towards the patients that they serve.

Returning to my own experiences with medical professionals, I have rather experienced what May explicates as the covenant than the code of ethics or philanthropy. This is particularly so in the case of the professionals that I visit regularly for general check-ups and the like. I therefore believe that May's solutions are both appealing and viable. On the other hand, to impose a whole new paradigm upon the entire medical profession appears to be a somewhat daunting task.

In conclusion, May's chapter is an interesting and highly educational piece of reading. I find it appealing on several levels; both for the way in which the concepts are explicated, its writing style, and the problems and solutions it addresses. I believe that the medical profession can greatly improve by adopting the suggestion of the covenant in all its relationships, which would benefit both doctors and patients.

Source

May, William F. "Code and Covenant or Philanthropy and Contract?"