Jonathan B. Imber, Trusting Doctors: The Decline of Moral Authority in American Medicine. Princeton, NJ: Princeton University Press, 2008. Pp. vix+ 275. $30.95

To willfully place one’s life in the hands of another can be a scary prospect. To do so requires a certain level of virtue and trust. The notion brings with it specific dynamics and relational tensions worthy of exploration. “Virtue” may sound too ethereal a subject for medical practice, but in many respects, medical effectiveness depends upon it. In Trusting Doctors, Jonathan B. Imber’s intention is to focus on the element of trust and the recent diminution of the physician’s professional authority in the larger public arena. Trust, most specifically, is fluid and encompasses a range of factors including the individual physician’s character, sociological reasoning and hospital-as-corporation. Each of these aspects receives attention as areas of negotiation which impact the doctor-patient relationship. In simpler terms, the complex modern medical endeavor depends upon the invisible virtue of trust in the patient. Imber hypothesizes that a layperson’s ability to trust a doctor will face greater and more complex challenges in the future as life spans are extended.

Though much has changed and will continue to change within the medical profession, what has remained unaltered is its tradition of making commitments to standards of character and morality. After the Introduction, the book is evenly divided into two separate sections which explore such a legacy. The first half of the work seeks to make one long argument expositing the religious heritage of modern medicine which was predominantly Protestant with later influence (and even confluence) of Roman Catholic perspectives. In this section, the professionalization of medicine coincides with the general decline of clerical authority as delineated by Imber. From this foundation, the second section of the book shifts in tone to evaluate several aspects that have led to a pathological distrust of not only the individual physician but the modern medical enterprise as a whole. The main subjects that Imber addresses are the received notion of the power of medicine by the general public, a brief modern history of bioethics and anxiety as experienced by both patient and doctor about the limits of medical science.

The method of argumentation is primarily comprised of sources from historical archives and sociological data. In other words, Imber strives to make strong and immediate correlations between historical occurrences (sermons, eulogies, commencement speeches, published literature by historical actors) and future struggles to trust doctors by integrating moderate historiography with sociological interpretation. The strength of the book does indeed lie in the utilization of historical references and examples since they best exhibit the mindset of the time as well as provide touchstones over recent history. Such concrete antecedents lend themselves quite easily to the basic premise that the modern predicament did not come about in a vacuum.

Trusting Doctors is truly an interdisciplinary work since it exhibits multiple aspects of the humanities (literature, philosophy, ethics, history, social science and religion). It should have immediate application to medical education and practice since Imber seeks to provide insight into the human condition, suffering, personhood, and offer a historical perspective on modern medical practice. Attention to these subjects always deserves greater attention since it facilitates nurturing skills of observation, analysis, empathy and self-reflection.

Overall, the book is quite accessible to anyone with an appetite for medical science, history of medicine, and/or social interpretation. The historical aspects are the most intriguing and the argument seems more cohesive in the first section of the book as compared to the second which follows more tangential and fragmented concerns.