Doctors are among the most consequential experts. Rightly so, because the stakes are highest when it comes to health, which is the foundation of a good life. For more than a century, physicians have exercised considerable authority and autonomy over patients, including the legal right to cut, drug, and examine them. This is based on the assumption that they have exclusive knowledge and ethics.
Because of the presumed knowledge asymmetry between doctors and patients, doctors are trusted to make decisions in the best interest of patients. The dependency on doctors increases because health services belong to the class of ”credence goods”, where consumers cannot judge the quality of the goods even after consumption. Last but not least, patients are physically and mentally ill and therefore not in the best condition to make decisions. As a result, the doctor-patient relationship has been paternalistic, and this has persisted despite concerted attempts to make it participatory.
But conditions are changing enormously. Digital technologies have put a wealth of knowledge, data, experience, and computing power directly into the hands of patients. The ubiquitous technologies have also given the normally silenced patient a public voice. The empowered patient can seek support and advice from people around the world at any time, from the comfort of his or her bedroom. They can order and try various alternative medical therapies without a doctor’s approval. They can publicly rate, review, and recommend doctors and shape their reputations. They can use digital devices to collect, analyze, and interpret data without physicians. In short, patients are empowered and agentic.
On the one hand, the digitally empowered patient can be seen as a pathway to a truly participatory doctor-patient relationship. On the other hand, these developments can also lead to distrust, anxiety, and conflict between physicians and patients. For better or worse, the availability of digital tools in the hands of the layperson has the potential to disrupt traditional power structures, challenge norms, reshape the doctor-patient relationship, and redefine medical professionalism. My dissertation will examine these changes in illuminating settings, unpacking what this means more broadly for experts, laypersons, and their relationship.
Social relevance and benefits
Trust between different segments of society, including experts and laypeople, has eroded and the divide threatens to widen due to easy access to diverse information. The knowledge gained from this dissertation will have tremendous implications for society, as we will be able to better understand and predict the different attitudes and actions of experts and laypersons on various issues. We can use this knowledge to build trust, good faith, and common ground with each other. Personally, I want to build a framework of relational ethics of experts and laypeople. Only then can we hope for long-term socially beneficial outcomes while preserving individual autonomy and dignity.