Medical Blame and Physician Hypocrisy

This paper broaches two issues regarding the physician-patient relationship. The first concerns whether a doctor’s hypocrisy undermines their authority with respect to advising and blaming patients. I argue that hypocrisy can only ever undermine a doctor’s authority to blame their patient. This conclusion foregrounds the second issue: the permissibility of doctors blaming their patients–what I term “medical blame” While patients may be blameworthy for their poor health in cases where that poorness results from health-impairing behaviors, many authors have argued that medical blame has no place in the medical encounter. I identify six worries against medical blame from the bioethics literature and respond to each, arguing that they do not decisively show that medical blame is always inappropriate. In closing, I demonstrate that doctors, if they are to retain their authority to blame their patients for health-impairing behaviors, possess a unique reason to abstain from health-impairing behaviors themselves.