cy on the part of the doctor and a commitment not to do intentional harm to the patient (Jones 164). Indeed, what could be called the "harm clause" of the Oath implies that doctors should pursue the course of treatment that is least likely in the doctor's judgment to do harm to the patient.
Further, given the existence of the Patient Self-Determination Act, which imposes an affirmative obligation on the medical-practitioner community to be accountable for enabling patient rights and access to information about their condition, as well as their options for treatment, concealing information from the patient about her own condition would create at least as many institutional problems as it might solve family ones. Were Mrs. Pericolo's true condition to be kept from her, she could hardly be permitted to participate in the decisions for her own treatment: Is it the intention of the children to decide their mother's course of physical treatment as well? Therefore, as important as the children's view of the matter might be, Updyke is under no obligation to honor their view. This is particularly important if Updyke has any reason to suspect that the children are not primarily engaged in their mother's interests, but even if they have their mother's best intertests in mind, Updyke would need to make very clear that the doctor's primary obligation is directly to the patient. It would be possible for Updyke to appeal to the authority of the PSDA, but that legalistic protection adds nothing particularly helpful to the issue fronts with which physician, children, and patients must content. It would be more proper for the physician to construct a strategy of discourse that protects the patient while giving respect to the wishes of the various constituencies involved in the case.
Katz describes the obligation of the doctor toward the patient in terms of the doctor's duty to honor observation of "the patients' plight" rather than some objective ...