Physicians' Duty of Compassion

1995 ◽  
Vol 4 (4) ◽  
pp. 426-433 ◽  
Author(s):  
Charles J. Dougherty ◽  
Ruth Purtilo

This is a time of change in American healthcare. Market forces are restructuring local delivery systems around competing managed care networks. Many leading proposals for healthcare reform intend a reshaping of the national healthcare marketplace itself. Periods of change create an opportunity to reassess traditional values and practices. Such reassessments can be used to help insure that current innovations and proposed reforms preserve and strengthen the best in the traditions of medicine. A legitimate focus of concern in the medical and medical ethics community has been the effect of these delivery system changes on the physician-patient relationship. For example, will the future American healthcare system support and encourage compassion by physicians? Suppose it does not. Would something of significant moral value have been lost? More pointedly, would a system that undervalued or frustrated physician compassion be incompatible with the moral obligations of physicians? In order to address these questions, we examine the meaning of compassion and the role it should play in the physician-patient relationship. We argue that compassion is a duty of all physicians. Because this is so, we believe that changes in the healthcare system must be judged, in part, by how well they protect and encourage compassionate conduct by physicians.

2006 ◽  
Author(s):  
Luigi Anolli ◽  
Fabrizia Mantovani ◽  
Alessia Agliati ◽  
Olivia Realdon ◽  
Valentino Zurloni ◽  
...  

1987 ◽  
Vol 12 (1) ◽  
pp. 55-97 ◽  
Author(s):  
Fran Carnerie

AbstractMany individuals develop a temporary state of cognitive and emotional impairment after being diagnosed with catastrophic illness. Thus, when crucial decisions about medical treatment are required, they are unable to assimilate information; or worse, the legal need to be informed can rival a psychological desire to not be informed. The Canadian informed consent doctrine is unresponsive to crisis and clinically impracticable, and so paradoxically compromises the integrity and autonomy it was designed to protect. Many aspects of the physician-patient relationship and clinical setting also undermine the philosophical values enshrined in this doctrine. This further jeopardizes the individual's integrity. The Article explores proposals for change such as delaying the informing and consenting, improving the concept of consent, and improving the role of the physician.


2021 ◽  
pp. bmjspcare-2020-002764
Author(s):  
Catherine Owusuaa ◽  
Irene van Beelen ◽  
Agnes van der Heide ◽  
Carin C D van der Rijt

ObjectivesAccurate assessment that a patient is in the last phase of life is a prerequisite for timely initiation of palliative care in patients with a life-limiting disease, such as advanced cancer or advanced organ failure. Several palliative care quality standards recommend the surprise question (SQ) to identify those patients. Little is known about physicians’ views on identifying and disclosing the last phase of life of patients with different illness trajectories.MethodsData from two focus groups were analysed using thematic analysis with a phenomenological approach.ResultsFifteen medical specialists and general practitioners participated. Participants thought prediction of patients’ last phase of life, i.e. expected death within 1 year, is important. They seemed to find that prediction is more difficult in patients with advanced organ failure compared with cancer. The SQ was considered a useful prognostic tool; its use is facilitated by its simplicity but hampered by its subjective character. The medical specialist was considered mainly responsible for prognosticating and gradually disclosing the last phase. Participants’ reluctance to such disclosure was related to uncertainty around prognostication, concerns about depriving patients of hope, affecting the physician–patient relationship, or a lack of time or availability of palliative care services.ConclusionsPhysicians consider the assessment of patients’ last phase of life important and support use of the SQ in patients with different illness trajectories. However, barriers in disclosing expected death are prognostic uncertainty, possible deprivation of hope, physician–patient relationship, and lack of time or palliative care services. Future studies should examine patients’ preferences for those discussions.


1988 ◽  
Vol 18 (2) ◽  
pp. 195-200 ◽  
Author(s):  
Albert R. Jonsen

The activity of prescribing therapeutic drugs is one of the most significant features of the physician-patient relationship. This activity must be understood in moral, as well as technical terms. The ancient Greek word for drug had three meanings, providing the outline for an ethics of medication: remedy, poison and magical charm. Corresponding to these three meanings are three ethical principles: competence in therapeutic application, avoidance of harm and honesty.


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