Abstract

Rilke's remark conjures up an officious array of well-meaning persons bent on completing our orderly passage from cradle to grave. They tidy our files cosily about us, inject us with extreme unction and slide us into the warm embrace of the undertaker. At the forefront of the array stands the doctor, part mechanic and part priest. His main task is to repair the living with resources whose effective and impartial allocation is a chief topic of medical ethics. But his role is not that of an impartial allocator: his patients want his partisan support. This builds a moral tension into a role played out where system meets patient, and one made instructively plain in the care of the dying. The system no doubt prefers death to be cheap and orderly but this thought may not move someone like Rilke wanting a death of his own. The doctor is then caught between his general duty to patients at large and his particular duty to the patient in front of him, a tension tautened for a Hippocratic promoter of health and life by a patient in search of an exit.