Indeed, some would say that doctors are acculturated to value their own autonomy more than that of their patients. Another crucial distinction in professional values is the law's strong commitments to open processes and disclosure. Law invites debate on most issues, using uncertainty and difference of opinion to stimulate discussion. Courts and judges, legislators, and administrative rulemakers adhere to a default norm of openness. In particular, court proceedings are public, and judges must publicly articulate the reasons for their decisions along with the rulings themselves.
Public scrutiny fosters debate and revision, assuring that democratic values are protected.
In contrast, medicine has a long tradition of confidentiality. Medical experts are not accustomed to offering explanations and reasons for their recommendations, particularly to laypersons. Medical institutions typically do not have well-developed, open procedures for debating and reviewing decisions and disputes. Much of the time, medicine strives to mask uncertainty rather than to reveal it. Physicians argue that this approach is necessary to protect and encourage patients who face risky and difficult interventions, and to maintain patients' trust in their doctors.