Physician outreach during a pandemic: shared or collective responsibility?

2021 ◽  
pp. medethics-2020-107127
Author(s):  
Elizabeth Lanphier
Keyword(s):  
Medical Profession ◽  
Medical Knowledge ◽  
Collective Responsibility ◽  
Shared Responsibility ◽  
World Medical Association ◽  
Individual Physician ◽  
World Medical Association Declaration ◽  
Medical Paternalism ◽  
The Individual ◽  
Declaration Of Geneva

In ‘Ethics of sharing medical knowledge with the community: is the physician responsible for medical outreach during a pandemic?’ Strous and Karni note that the revised physician’s pledge in the World Medical Association Declaration of Geneva obligates individual physicians to share medical knowledge, which they interpret to mean a requirement to share knowledge publicly and through outreach. In the context of the COVID-19 pandemic, Strous and Karni defend a form of medical paternalism insofar as the individual physician must reach out to communities who may not want, or know to seek out, medical advice, for reasons of public health and health equity. Strous and Karni offer a novel defence of why physicians ought to intervene even in insular communities, and they offer suggestions for how this could be done in culturally sensitive ways. Yet their view rests on an unfounded interpretation of the Geneva Declaration language. More problematically, their paper confuses shared and collective responsibility, misattributing the scope of individual physician obligations in potentially harmful ways. In response, this reply delineates between shared and collective responsibility, and suggests that to defend the obligation of medical outreach Strous and Karni propose, it is better conceptualised as a collective responsibility of the medical profession, rather than a shared responsibility of individual physicians. This interpretation rejects paternalism on the part of individual providers in favour of a more sensitive and collaborative practice of knowledge sharing between physicians and communities, and in the service of collective responsibility.

scholarly journals Holistic model as a challenge for the medical profession

2020 ◽  
Vol 10 (1) ◽  
pp. 173-194
Author(s):  
Nina Putała
Keyword(s):  
Medical Profession ◽  
Medical Knowledge ◽  
Holistic Approach ◽  
Subjective Perception ◽  
Holistic Model ◽  
Relationship Model ◽  
Postmodern Philosophy ◽  
Definition Of ◽  
The Individual ◽  
The Right

The article presents a doctor–patient relationship model based on the assumptions of a holistic approach to the patient. The author draws attention to selected patients’ needs, ones taken into account in this model. These are the right to autonomy and an individualised approach to the patient. These issues, considered in relation to philosophy, show a conflict between patients’ values and aspirations and doctors’ values and their experience. Nowadays, patients’ needs are protected by consumer rights as well as being strengthened by postmodern philosophy, which shapes society’s awareness of various definitions of health and underlines the right of the individual to self‐determination. This situation creates an incredible challenge for doctors because attempts to assist is, according to medical knowledge, associated with an inevitable collision with the subjective perception of a patient’s health. Because of this issue, the author considers it necessary to enquire about the needs and aspirations of not so much patients as doctors themselves. It is assumed that the definition of what is currently important for this group determines the scope of any possible admission or intentional ignorance of patients’ needs.

Cocculus and how far homœopathy can be taught

1980 ◽  
Vol 69 (02) ◽  
pp. 95-104
Author(s):  
Georg Von Keller
Keyword(s):  
At Risk ◽  
Nervous System ◽  
Chronic Conditions ◽  
Medical Profession ◽  
Early Years ◽  
Case Material ◽  
Specific Approach ◽  
Individual Physician ◽  
The Individual ◽  
Similar Development

Summary Cocculus is presented pharmacologically, as a narcotic and intoxicant. It is shown that the remedy acts chiefly on the nervous system and how this predilection for the nervous system may be discerned even with symptoms involving the mucosa, such as cough and hoarseness. The symptoms differentiating this remedy from others are considered in relation to a number of indications—seasickness, dizziness, headache, dysmenorrhoea, and cough—demonstrating them on the basis of both the literature and the author's own case material.It is shown how this remedy with its powerful action was during the early years of homœopathy used almost exclusively to treat serious illnesses, where life was at risk, and how this related to a different attitude of the medical profession at that time, when chronic conditions were considered beneath one's notice. It seems to the author that this in fact was one of the reasons why from the early days of homœopathy until well into the present century, doctors using, the “specific” approach in homœopathy were considerably in the majority compared to the “Hahnemannians’. An attempt is then made to show that the individual physician goes through a similar development, and that the homœopathy of specifics is much more easily taught than the Hahnemannian approach.

Evidence-based Practice regarding knowledge, attitude and perceived barriers of Mangalore Physical Therapists: A Survey

2020 ◽  
Vol 11 (4) ◽  
pp. 7056-7063
Author(s):  
Vineel P ◽  
Gopala Krishna Alaparthi ◽  
Kalyana Chakravarthy Bairapareddy ◽  
Sampath Kumar Amaravadi
Keyword(s):  
Response Rate ◽  
Evidence Based Practice ◽  
Physical Therapists ◽  
Medical Profession ◽  
Demographic Data ◽  
Perceived Barriers ◽  
Hard Copy ◽  
Evidence Based ◽  
Research Committee ◽  
The Individual

  Evidence-based Practice is defined as usage of current best evidence which is conscientious, explicit and judicious in deciding on the care of the individual. It is one of the vital decision-making processes in the medical profession. Though India is renowned as a center for medical education, there is scarcity regarding the literature on evidence-based practice. The survey aims to identify the prevalence of evidence-based practice among the physical therapists of Mangalore. The study protocol submitted to scientific research committee and Ethical institutional committee, K.M.C. Mangalore Manipal University. On approval, the questionnaire had been distributed among the physical therapists of Mangalore through mails and in the written form. The questionnaire consists of questions divided into eight sections: 1) consent form 2) current practice status; 3) demographic data; 4) behavior; 5) previous knowledge of E.B.P. resources; 6) skills and available resources; 7) Opinions regarding E.B.P.; 8)Perceived barriers regarding E.B.P. The emails were sent through Google forms to all the physical therapists, and hard copies were distributed among the selected physical therapists. The response rate for the emails was 13.1%. The response collected through hard copies was 178, whereas total hard copies distributed was 320, the participants rejected some due to lack of interest. In total, including emails and hard copy questionnaire 205 was the response rate in which all were practicing physical therapy as their primary profession. The findings of the study will pave the way to identify the status of evidence-based practice as well as help in designing promotional programmers for evidence-based practice.

Michel Foucault and Western Medicine

2019 ◽  
Vol 29 (2) ◽  
pp. 64-81
Keyword(s):  
Western Medicine ◽  
18Th Century ◽  
Medical Knowledge ◽  
Social Medicine ◽  
Western Society ◽  
1960S And 1970S ◽  
The Veil ◽  
The 1960S ◽  
The Individual ◽  
The 19Th Century

The article analyzes Michel Foucault’s philosophical ideas on Western medicine and delves into three main insights that the French philosopher developed to expose the presence of power behind the veil of the conventional experience of medicine. These insights probe the power-disciplining function of psychiatry, the administrative function of medical institutions, and the role of social medicine in the administrative and political system of Western society. Foucault arrived at theses insights by way of his intense interest in three elements of the medical system that arose almost simultaneously at the end of the 18th century - psychiatry as “medicine for mental illness”, the hospital as the First and most well-known type of medical institution, and social medicine as a type of medical knowledge focused more on the protection of society and far less on caring for the individual. All the issues Foucault wrote about stemmed from his personal and professional sensitivity to the problems of power and were a part of the “medical turn” in the social and human sciences that occurred in the West in the 1960s and 1970s and led to the emergence of medical humanities. The article argues that Foucault’s stories about the power of medical knowledge were philosophical stories about Western medicine. Foucault always used facts, dates, and names in an attempt to identify some of the general tendencies and patterns in the development of Western medicine and to reveal usually undisclosed mechanisms for managing individuals and populations. Those mechanisms underlie the practice of providing assistance, be it the “moral treatment” practiced by psychiatrists before the advent of effective medication, or treating patients as “clinical cases” in hospitals, or hospitalization campaigns that were considered an effective “technological safe-guard ” in the 18th and most of the 19th century.

The Entextualization of Ayurveda as Intellectual Property

2012 ◽  
Vol 19 (3) ◽  
pp. 313-343 ◽  
Author(s):  
Matthew Wolfgram
Keyword(s):  
Intellectual Property ◽  
Global Economy ◽  
Medical Knowledge ◽  
Linguistic Anthropology ◽  
Medical Discourse ◽  
Complex Nature ◽  
Multiple Sources ◽  
The Social ◽  
Rights Discourse ◽  
The Individual

AbstractThis article documents the practices of pharmaceutical creativity in Ayurveda, focusing in particular on how practitioners appropriate multiple sources to innovate medical knowledge. Drawing on research in linguistic anthropology on the social circulation of discourse—a process calledentextualization—I describe how the ways in which Ayurveda practitioners innovate medical knowledge confounds the dichotomous logic of intellectual property (IP) rights discourse, which opposes traditional collective knowledge and modern individual innovation. While it is clear that these categories do not comprehend the complex nature of creativity in Ayurveda, I also use the concept of entextualization to describe how recent historical shifts in the circulation of discourse have caused a partial entailment of this opposition between the individual and the collectivity. Ultimately, I argue that the method exemplified in this article of tracking the social circulation of medical discourse highlights both the empirical complexity of so-called traditional creativity, and the politics of imposing the categories of IP rights discourse upon that creativity, situated as it often is, at the margins of the global economy.

MEDICAL FALLIBILITY

PEDIATRICS ◽  
1977 ◽  
Vol 60 (2) ◽  
pp. 243-243
Author(s):  
Gorovitz ◽  
MacIntyre ◽  
Keyword(s):  
Medical Error ◽  
Medical Profession ◽  
Medical Science ◽  
Medical Problem ◽  
Medical Sciences ◽  
Physician Patient Relationship ◽  
The Public ◽  
Iatrogenic Illness ◽  
The Individual ◽  
Physician Patient

At present, the typical patient is systematically encouraged to believe that his physician will not make a mistake, even though what the physician does may not achieve the desired medical objectives, and even though it cannot be denied that some physicians do make mistakes. The encouragement of this inflated belief in the competence of the physician is of course reinforced by the practice of not keeping systematic and accessible records of medical error. Yet everyone knows that this is a false confidence . . . the current high incidence of iatrogenic illness constitutes a medical problem of enormous proportions, well recognized within government agencies and segments of the medical profession, but only dimly suspected by the public at large. There is still a relatively high probability of a patient suffering from medical error. What patients and the public have to learn is to recognize, accept, and respond reasonably to the necessary fallibility of the individual physician. The physician-patient relationship has to be redefined as one in which necessarily mistakes will be made, sometimes culpably, sometimes because of the state of development of the particular medical sciences at issue, and sometimes, inevitably, because of the inherent limitations in the predictive powers of an enterprise that is concerned essentially with the flourishing of particulars, of individuals. The patient and the public therefore must also understand that medical science is committed to the patient's prospering and flourishing, and that the treatment of the patient is itself a part of that science and not a mere application of it.

I nuovi scambi tra medici e pazienti: le parole della medicina

2021 ◽  
Vol 9788879169776 ◽  
pp. 35-45
Author(s):  
Antonio M. Carrassi
Keyword(s):  
Search Engines ◽  
Health Workers ◽  
Medical Knowledge ◽  
Medical Field ◽  
Average Life ◽  
Average Life Span ◽  
Research Activities ◽  
Field Information ◽  
The One ◽  
The Individual

Medicine showed enormous progresses since the middle of the last century and, thanks to the overwhelming research activities, which characterized that period, the average life span of people has increased extraordinarily. Many diseases that once were considered incurable are now being successfully treated. However, the disease has often been placed at the core of the clinical process rather than the person, the individual, the patient. Even in recent years, the patient doesn’t always find in his doctor the appropriate degree of empathy, and the level of communication that would be desirable. Moreover, today we are living an extraordinary development and spreading use of digital resources and search engines. Patients exploit these tools to obtain any kind of information, included the one in the medical field. Information technology and search engines play an extremely important role in medicine, and they can be seen a pivotal communication instrument between clinicians and patients, although they can also provide inaccurate or incorrect feedback to laypeople looking for answers to health questions, who do not have enough medical knowledge to evaluate the reliability of the source. This problem has been raised by clinicians and, more generally, by health workers, who today operate with a view to greater psychological proximity to the patient, passing from a so-called Disease Centred Medicine to a clinical practice much more sensitive to the needs of the patient, to his experience, to the context in which he lives, thus achieving a Patient Centred Medicine. Listening, attention, empathy and the words that a clinician is required to use towards each patient, during the clinical routine, take on more and more value for a correct doctor-patient exchange and alliance.

Recommended Policies for Uses of Human Tissue in Research, Education, and Quality Control

1999 ◽  
Vol 123 (4) ◽  
pp. 296-300 ◽  
Author(s):  
William Grizzle ◽  
Wayne W. Grody ◽  
Walter W. Noll ◽  
Mark E. Sobel ◽  
Sanford A. Stass ◽  
...  
Keyword(s):  
Quality Control ◽  
Human Tissue ◽  
Medical Knowledge ◽  
Best Interests ◽  
Direct Patient Care ◽  
Research Education ◽  
The Public ◽  
Medical Specialists ◽  
The Individual ◽  
Knowledge Interests

Abstract As recipients of tissue and medical specimens, pathologists and other medical specialists regard themselves as stewards of patient tissues and consider it their duty to protect the best interests of both the individual patient and the public. The stewardship of slides, blocks, and other materials includes providing, under appropriate circumstances, patient materials for research, education, and quality control. The decision to provide human tissue for such purposes should be based on the specific (ie, direct patient care) and general (ie, furthering medical knowledge) interests of the patient and of society. The same standards of responsibility should apply to all medical professionals who receive and use specimens. This document proposes specific recommendations whereby both interests can be fostered safely, ethically, and reasonably.

scholarly journals Assessing and Documenting the Cognitive Performance of Family Medicine Residents Practicing Outpatient Medicine

2014 ◽  
Vol 6 (3) ◽  
pp. 526-531 ◽  
Author(s):  
Allen F. Shaughnessy ◽  
Katherine T. Chang ◽  
Jennifer Sparks ◽  
Molly Cohen-Osher ◽  
Joseph Gravel
Keyword(s):  
Family Medicine ◽  
Cognitive Performance ◽  
Cognitive Skills ◽  
Medical Knowledge ◽  
Time Consistency ◽  
Faculty Members ◽  
Knowledge Domain ◽  
Ambulatory Medicine ◽  
The Individual ◽  
Over Time

Abstract Background Development of cognitive skills for competent medical practice is a goal of residency education. Cognitive skills must be developed for many different clinical situations. Innovation We developed the Resident Cognitive Skills Documentation (CogDoc) as a method for capturing faculty members' real-time assessment of residents' cognitive performance while they precepted them in a family medicine office. The tool captures 3 dimensions of cognitive skills: medical knowledge, understanding, and its application. This article describes CogDoc development, our experience with its use, and its reliability and feasibility. Methods After development and pilot-testing, we introduced the CogDoc at a single training site, collecting all completed forms for 14 months to determine completion rate, competence development over time, consistency among preceptors, and resident use of the data. Results Thirty-eight faculty members completed 5021 CogDoc forms, documenting 29% of all patient visits by 33 residents. Competency was documented in all entrustable professional activities. Competence was statistically different among residents of different years of training for all 3 dimensions and progressively increased within all residency classes over time. Reliability scores were high: 0.9204 for the medical knowledge domain, 0.9405 for understanding, and 0.9414 for application. Almost every resident reported accessing the individual forms or summaries documenting their performance. Conclusions The CogDoc approach allows for ongoing assessment and documentation of resident competence, and, when compiled over time, depicts a comprehensive assessment of residents' cognitive development and ability to make decisions in ambulatory medicine. This approach meets criteria for an acceptable tool for assessing cognitive skills.

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