Power is an inevitable aspect of all social relationships and is inherently neither good nor bad. Doctors need power to fulfil their professional responsibilities to multiple constituencies, including patients, communities and themselves. Patients need power to formulate their values, express and fulfil their health needs and fulfil their responsibilities. However, both parties can use or abuse power. The ethical effectiveness of the healthcare system can be maximised by allowing doctors and patients to develop 'adult-adult' rather than 'adult-child' relationships that respect and enable autonomy, responsibility, fidelity and humanity. Even in adult-adult relationships, conflicts and complexities arise. Disagreement between doctors and patients can encourage paternalism, but this can best be resolved through negotiated care. Another area of conflict relates to doctors' 'dual agency' for both patients and the community.
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