Altruism, Self-interest, and Medical Ethics

Abstract

To the Editor. —I write concerning the editorial by Dr Pellegrino 1 and the letter in response by Dr Tiemstra and the reply by Dr Pellegrino. 2 Dr Pellegrino states that the thrust of his article is paternalism. I think both he and Dr Tiemstra, however, have more fundamental contradictions in their thinking. The key contradiction is the principle of altruism. The basic principle of altruism is that man has no right to exist for his own sake, that service to others is the only justification for existence, and that self-sacrifice is the highest moral duty, virtue, and value. Do not confuse altruism with kindness, good-will, or the respect for the rights of others. These are not primaries, but consequences that, in fact, altruism makes impossible. 3 The most moral code is the most rational code, ie, objective. The most moral thing that any professional, including physicians, can do in