@Cynic: I think this was precisely the point Epstein was trying to get at. With a system that is unfair to begin with, changing the rules within that system to 'make it more ethical' is simply playing the system's game and stifling the possibility for critical discourse and the development of a more just system. Although I confess I haven't read Marx thoroughly, my feeling is that Marx would support Epstein. Demanding a 'better ethics' is akin to demanding more 'better wages'. The power relations remain the same, the system hasn't changed for the better - or at all.

@angry doc: Although I was unfortunately unable to stay to the end of the debate, my general sense was that Epstein was cautioning the audience (and by extension the medical profession) not to restart the entire debate about reforming and reviewing "medical ethics" per se, but to in fact politically challenge the medical institutions they were working for. To him, the ethics were fine as they were already, however keeping them within a solely 'ethical' (and medical) framework absolved doctors from interrogating the ways in which 'ethical' issues have even come to be defined as such - a consequence of the political and social influence of the medical industry in wider society.