The limits of consumerism in the physician-patient relationship

Mary Anne Bobinski1

1 Allard School of Law, University of British Columbia, Vancouver, BC Canada V6T1Z1

It is often said that health care has moved from paternalism, in the form of “doctor knows best,” to consumerism, in which patients expect to be able to obtain treatment consistent with their values and preferences. The contested nature of the physician-patient relationship is reflected in a range of legal responses to conflicts in the relationship.  This presentation explores some of the limits to consumerism, with a particular focus on legal responses to conflicting values or norms.  Considerable attention has been devoted to values conflicts in areas such as abortion and end of life care. This presentation focuses more broadly on the legal response to values conflicts in areas such as risky therapies, egg donation, pre-exposure prophylaxis for HIV, and extreme plastic surgery. The presentation will also consider the implications of this analysis for potential future conflicts over the development of uterine transplants.  The discussion includes selected examples from Australia, Canada, and the U.K.


Mary Anne Bobinski, B.A., J.D., LL.M., is a Professor at the Allard School of Law, where she served as Dean from 2003 to 2015. Before joining UBC, she was the John and Rebecca Moores Professor of Law and Director of the Health Law and Policy Institute at the University of Houston Law Center.  She has served as a visiting scholar at the Petrie-­Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School, the University of Sydney Law School, the Melbourne Law School and the Faculty of Law at Oxford University, where she also held a Plumer Visiting Research Fellowship at St. Anne’s College.