Cultural Fusion in Physician–Patient Communication and Decision Making in Japan

2021 ◽  
Author(s):  
Miho Iwakuma ◽  
Daisuke Son
Keyword(s):  
Palliative Care ◽  
Psychosocial Aspects ◽  
Social Changes ◽  
Patient Centeredness ◽  
Clinical Communication ◽  
Sensitive Topics ◽  
The 1960S ◽  
Patient Relationships ◽  
Physician Patient ◽  
Cultural Fusion

The term “cinemeducation” was coined by Matthew Alexander in 2002, and according to P. Ravi Shankar, it refers to the use of clips from movies and videos to educate medical students and residents on the psychosocial aspects of medicine. As a counterbalance to the biomedicine-centric medical curricula, cinemeducation deals with the psychosocial aspects of medicine and sensitive topics in healthcare, including but not limited to depression, family and marital counseling, doctor–patient relationships, family systems, addiction, mental illness, cultural competency, and foreign patients and their healthcare beliefs. Cinemeducation is particularly useful when the viewing is followed by a discussion, which engages students in active learning of clinically relevant concepts such as informed consent (IC), palliative care, and patient-centeredness. In other words, cinemeducation provides students in the healthcare fields with opportunities to learn about the humanistic aspects of medicine by watching movies or clips that provide insight into human experiences and challenges in medicine. A famous Japanese medical TV series, Shiroi Kyoto (The Great White Tower) will be examined to discuss the cultural fusion that has occurred in Japan, specifically with regard to clinical communication. Based on a novel authored by Toyoko Yamazaki in the 1960s, this series is of interest because the novel was made into a drama twice, first in the 1970s and again in 2003. Accordingly, several significant changes in health communication are noticeable between the first and second versions. Social changes in paternalism in medicine, palliative care, and IC that were adapted from the West and localized in Japan, as cultural fusion are evident in several noteworthy scenes.

Foucault, Lenin, and Western Marxism

2019 ◽  
Vol 29 (2) ◽  
pp. 251-267
Keyword(s):  
Public Intellectual ◽  
Philosophical Tradition ◽  
Real Problem ◽  
Social Changes ◽  
Revolutionary Movement ◽  
History Of ◽  
The 1960S ◽  
Significant Figures ◽  
Marxist Tradition ◽  
Western Marxism

This article others a brief historical account of the complex relationship between Michel Foucault and certain theorists in the Western Marxist philosophical tradition. In the context of the history of the “short twentieth century,” Western Marxism is an intellectual trend based on an interpretation of non-Western revolutionary praxis (by Bolsheviks, Maoists, Guevaristas, etc.). Comparative analysis of several schematic portraits - of Lenin’s revolutionary intellectual, of traditional as opposed to organic intellectuals in Gramsci, and of Foucault’s public intellectual - shows that Foucault in a certain instances was not an external enemy of the Western Marxist tradition, but rather its internal critic. Foucault comes across as a revisionist who engaged in a debate with Lenin about the strategy of the revolutionary movement in France of the 1960s and the 70s. Foucault’s criticism of Leninism unexpectedly turns out to be consistent with the basic struggle of post-WWII Western Marxism to find an alternative to the Bolshevik experience of revolution. This deliberate concurrence makes Foucault one of the significant figures in the history of late Western Marxism, but this becomes a real problem for current historians of neo-Marxist thought when coupled with his generally anti-Marxist views. The article discusses two possible solutions to this problem devised by Perry Anderson and Daniel Bensaid. Anderson’s description of the role of Foucault in the fate of Western Marxism is limited to conceptual questions about the relationship between Marxism and (post) structuralism. Bensaid tries to explain how Foucault fits into the Marxist tradition by appealing to social changes, specifically the changing ideology of capitalist society (in the spirit of The New Spirit of Capitalism by Luc Boltanski and Ève Chiapello). Building on Bensaid’s work, the article shows the link between Foucault’s position on public intellectuals and the crisis of the revolutionary movement of the last half-century, in particular by reference to the famous “Iranian episode” in Foucault’s biography.

Patient-Centered Care and Autonomy: Shared Decision-Making in Practice and a Suggestion for Practical Application in the Critically Ill

2019 ◽  
Vol 35 (11) ◽  
pp. 1352-1355
Author(s):  
Marianna V. Mapes ◽  
Peter A. DePergola ◽  
William T. McGee
Keyword(s):  
Decision Making ◽  
Palliative Care ◽  
Critically Ill ◽  
Care Service ◽  
Clinical Care ◽  
Patient Centered Care ◽  
Practical Application ◽  
Patient Centeredness ◽  
Patient Centered ◽  
Centered Care

Decision-making for the hospitalized dying and critically ill is often characterized by an understanding of autonomy that leads to clinical care and outcomes that are antithetical to patients’ preferences around suffering and quality of life. A better understanding of autonomy will facilitate the ultimate goal of a patient-centered approach and ensure compassionate, high-quality care that respects our patients’ values. We reviewed the medical literature and our experiences through the ethics service, palliative care service, and critical care service of a large community teaching hospital. The cumulative experience of a senior intensivist was filtered through the lens of a medical ethicist and the palliative care team. The practical application of patient-centered care was discerned from these interactions. We determined that a clearer understanding of patient-centeredness would improve the experience and outcomes of care for our patients as well as our adherence to ethical practice. The practical applications of autonomy and patient-centered care were evaluated by the authors through clinical interactions on the wards to ascertain problems in understanding their meaning. Clarification of autonomy and patient-centeredness is provided using specific examples to enhance understanding and application of these principles in patient-centered care.

scholarly journals Physicians’ views on the usefulness and feasibility of identifying and disclosing patients’ last phase of life: a focus group study

2021 ◽  
pp. bmjspcare-2020-002764
Author(s):  
Catherine Owusuaa ◽  
Irene van Beelen ◽  
Agnes van der Heide ◽  
Carin C D van der Rijt
Keyword(s):  
Palliative Care ◽  
Organ Failure ◽  
Care Quality ◽  
Patient Relationship ◽  
Physician Patient Relationship ◽  
Focus Group Study ◽  
Timely Initiation ◽  
Care Services ◽  
Palliative Care Services ◽  
Physician Patient

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.

Integrating social class and privilege in the community medicine curriculum

2017 ◽  
Vol 52 (3) ◽  
pp. 228-235
Author(s):  
Christopher Haymaker ◽  
Amber Cadick ◽  
Allison Seavey
Keyword(s):  
Social Class ◽  
Hidden Variables ◽  
Therapeutic Approaches ◽  
Physician Patient Relationship ◽  
Health Curriculum ◽  
Group Format ◽  
Resident Physicians ◽  
Patient Health ◽  
Patient Relationships ◽  
Physician Patient

Social class and privilege are hidden variables that impact the physician–patient relationship and health outcomes. This article presents a sample of activities from three programs utilized in the community health curriculum to teach resident physicians about patients within context, including how social class and privilege impact physician–patient relationships and patient health. These activities address resident physicians’ resistance to discussion of privilege, social class, and race by emphasizing direct experience and active learning rather than traditional didactic sessions. The group format of these activities fosters flexible discussion and personal engagement that provide opportunities for reflection. Each activity affords opportunities to develop a vocabulary for discussing social class and privilege with compassion and to adopt therapeutic approaches that are more likely to meet patients where they are.

Physician—Patient Relationships

1985 ◽  
Vol 78 (1) ◽  
pp. 15-21
Author(s):  
Robert B. Howard
Keyword(s):  
Patient Relationships ◽  
Physician Patient

scholarly journals Obligations, consent and contracts in Scots law: re-analysing the basis of medical malpractice liability in light of Montgomery v Lanarkshire Health Board

Legal Studies ◽  
2021 ◽  
pp. 1-21
Author(s):  
Jonathan Brown
Keyword(s):  
Informed Consent ◽  
Legal System ◽  
Medical Malpractice ◽  
Health Board ◽  
Medical Negligence ◽  
University Hospitals ◽  
Malpractice Liability ◽  
Patient Relationships ◽  
Physician Patient ◽  
Medical Regime

Abstract Professors MacQueen and Thomson have defined ‘contract’, within Scots law, as denoting ‘an agreement between two or more parties having the capacity to make it, in the form demanded by law, to perform, on one side or both, acts which are not trifling, indeterminate, impossible or illegal’. This definition reflects the fact that Scottish contracts are underpinned by consent, rather than by ‘consideration’. This, naturally, has the potential to be of great significance within the context of physician/patient relationships, particularly since the 2006 case of Dow v Tayside University Hospitals NHS Trust acknowledged that these relationships could be contractual in nature. This observation is of renewed importance since the landmark decision in Montgomery v Lanarkshire Health Board, which found that physicians must ensure that they obtain full and freely given ‘informed consent’ from their patients, prior to providing medical services. In light of the present medical regime which requires ‘doctor and patient [to] reach agreement on what should happen’, the basis of liability for medical negligence, in Scotland, requires reanalysis: ‘To have a contract only when the patient pays is not consistent with a legal system which has no doctrine of consideration in contract’.

scholarly journals Džon i Žaklina Kenedi: politika, kultura i „nova granica“ odevanja

2016 ◽  
Vol 10 (4) ◽  
pp. 857
Author(s):  
Simona Čupić
Keyword(s):  
Political Affiliation ◽  
Social Changes ◽  
Specific Kind ◽  
The Public ◽  
Contemporary Politics ◽  
Internal Politics ◽  
Art And Culture ◽  
History Of ◽  
The 1960S ◽  
The Cold War

Jacqueline Kennedy’s style is one of the mainstays of the history of fashion and popular culture, as well as contemporary politics. John Kennedy’s way of dressing garnered much less attention. Even though, at first glance, not as interesting as the first lady’s “fashion sense”, the president’s style was no less thought-out. If, however, we view the changes in clothing as social changes and a determinant of various kinds of social differentiation: marital status, sex, occupation, religious and political affiliation, the way in which the Kennedys were presented to the public becomes more interesting – from the (carefully planned) photos and appearances to art and culture. Having in mind that the 1960s were a time when the appropriation of popular and fictional came back into modern art, and that general changes inherent in the new lifestyle, as well as a layered image of American internal politics, and the cold war map of the world, the carefully thought-out image of the presidential couple can be viewed as a specific kind of metaphor for a complicated time.

scholarly journals Working Time as a Measure of Acceleration of the Serbian Society at the Turn of the Century: Anthropological Analysis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ljubica Milosavljević ◽  
Bogdan Dražeta
Keyword(s):  
Private Sector ◽  
Working Hours ◽  
Private Life ◽  
Turn Of The Century ◽  
Working Time ◽  
Social Changes ◽  
Anthropological Fieldwork ◽  
The 1960S ◽  
The One ◽  
Almost All

Multiple processes in modern Serbia occurred at the end of the twentieth and the beginning of the twenty first century. Almost all of them regard political, economic, and social changes. Influences caused by these changes can be seen in the social template across the spectrum of plans, encompassing various spheres of life of individuals from business to private, all the way to the point where this division, for many, is gradually disappearing. In that sense, this paper will follow the most anthropologically interesting example of research, the one that follows the influences of the undertaken reform processes and observed changes. This is the example that regards the experience and evaluation of time among employed inhabitants of Belgrade, the capital of Serbia. The aim of this paper was to refer to the results of anthropological fieldwork conducted in 2005, which focused on the experiences, strategies and expectations of employed Belgraders in terms of their working hours and certain temporal boundaries that characterize it. Due to the increasingly intensive business contacts with foreign partners and colleagues since 2000, the working hours of employees were analyzed in a narrower context, as they were on the long list of adjustments, mostly to Western influences. These contacts were not only more frequent after the period of the 1990s, which, among other things, is characterized by a sudden break in cooperation with foreigners, but were often dictated by the EU integration process, the increase of the private sector in which operated companies were oriented towards profit, and the acceleration of time. The last aspect was examined in 2005 through a sample comprising 30 interlocutors of various business backgrounds. The ethnographic material was categorized and analyzed with regard to the differentiation of respondents by age. Fifteen respondents were chosen to represent the older generation (born in the 1940s and 1950s) and as many the younger generation (born in the 1960s and 1980s). The blurring of the boundaries between the employees’ business and private life in Belgrade became more marked at the turn of the century, and it could be clearly stated through the example of working time. Differences between the period of socialism and the period of reforms since the 1990s relate also to a sense of insecurity and fear of losing one's job or having inadequate work, and the simultaneous development of the private sector, which is characterized by stricter rules for employees. More intensive was the influence of business on the private domain of life, but also the intrusion of the private into business life. This has become a necessity and a pledge of individual functioning on both levels, which show combined characteristics of acceleration through the increase of obligations.

Physician Patient-Centeredness Measure

2006 ◽  
Author(s):  
Dorte Kjeldmand ◽  
Inger Holmström ◽  
Urban Rosenqvist
Keyword(s):  
Patient Centeredness ◽  
Physician Patient
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