The term “social contract” has long been used to define medicine’s relationship with society. A “contract” is a two-way agreement that has both explicit and implicit expectations for both parties. The expectations of medicine by society have been described in the literature and include placing the patient’s interests above our own (altruism), ensuring competence, addressing issues of societal concern and being devoted to the public good. Conversely, the medical profession has expectations of society that include self-regulation, an adequately funded health care system and a role in public policy determination.

Altruism is core to the public trust of physicians, public confidence in the health care system, and the authority of advice by physicians regarding public policy on health and health care. A recent study reported that trust in the health care system and physicians were low in the...

You do not currently have access to this content.