In a career that spanned more than five decades, from the 1950s into the 21st century, Dr. Phillip I. Lerner witnessed vast transformations in medicine. But as his son, Dr. Barron H. Lerner, writes in this exquisitely insightful new memoir, none of the changes was more profound than the evolution of the doctor-patient relationship.
The son revered the father, viewing him as a model of solicitude and benevolence, unconditionally devoted to his patients. Yet when he got the chance to review his father's journals, going back to 1961, he realized that the older man's ethical compass differed drastically from his own.
Phillip Lerner, the son of a Polish immigrant, came of age in an era when the doctor (almost always male) was king — the best and final arbiter in all medical matters. Patients could be patronized and even lied to, and the doctor could take it upon himself to accelerate the death of a terminally ill patient whom he deemed to be suffering excessively.
As late as 1996, the younger Dr. Lerner writes, his father placed himself over the body of a pulseless woman to prevent colleagues from trying to resuscitate her. And when his own elderly relatives became sick, Phillip Lerner saw little wrong in directing their care.
Today "patient autonomy" has become the norm, and the younger Dr. Lerner is a fervent advocate of it. Modern ethical standards make caring for family members "an absolute taboo," he writes, since lack of objectivity increases the likelihood of questionable decisions.