scholarly journals 患者利益至上——傳統情懷與現實挑戰

2012 ◽  
Vol 10 (2) ◽  
pp. 35-49
Author(s):  
Li LIANG
Keyword(s):  
Medical Practice ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Moral Principles ◽  
Moral Perfection ◽  
The People ◽  
Digital Commons ◽  
Self Interest ◽  
Current Medical Practice ◽  
Traditional Medical Practice

LANGUAGE NOTE | Document text in Chinese; abstract also in English.以患者利益為重被視為醫學的傳統美德，也是醫生的職責。它的基本宗旨是將患者的利益放在首位。當醫生的利益不受其他因素干擾時，他們較能承擔“患者利益至上”這一責任。而當出現利益衝突時，醫生則會面臨特殊的挑戰，有時還有可能需要做出一定的自我犧牲。西方醫學倫理在強調醫師職業道德的同時也通過制度建設盡量避免利益衝突的發生，以更好維護患者和醫生雙方的利益。中國傳統醫學倫理中，“患者利益至上”雖然沒有作為具體道德原則予以規定，但在醫療實踐中卻常常可以體現出醫生“患者利益至上”的情懷。之所以如此，與儒家文化的影響密不可分。儒家“仁”的思想強調愛人，提出對待病人要“皆如至親之想”。儒家將愛親的情感擴展到病人身上，同時也將“博施於民而能濟眾”視為自己高尚的道德追求。在義利關係問題上，儒家提出了獲取利益的正當性問題，即“不以其道得之，不處也”。醫生受其影響，反對“恃己所長，專心經略財物”，強調維護病人健康利益的重要性。另一方面，儒家修身的實踐精神有助於“仁”、“義”等從一種自然情感上升為真正意義上的道德德性，而古代重視家庭親情的傳統對於醫生的品德修養也起到了重要作用。醫生在修德的同時注重自身專業技能的訓練和提高，良好品德和精湛的技藝為維護患者的利益提供了重要條件。目前，患者利益至上的職業精神正面臨著經濟、政治、科技等多方面的挑戰，中國傳統文化缺失帶來的個體道德情感的弱化使這一問題更為突出。The doctor-patient relationship in China is currently experiencing a crisis of trust brought on by the absence of traditional morals and values in healthcare. The Confucian doctrine of ren (benevolence) is based on the possibility of moral perfection in humanity, which in turn guides one how to treat others in family and non-family social relationships. Ren as a relational virtue is particularly important for the doctor-patient relationship. That is why the Confucian idea of “treating a patient like a family member” was popular in traditional medical practice. However, current medical practice is designed around the people who deliver the care, who happen to pay more attention to their own interests and benefits than those of their patients.The essay contends that although Confucian teaching does not exclude the pursuit of self-interest or self-benefit, it does emphasize virtue and personal character, especially for doctors. No doctor is expected to make a profit that is not within the scope of moral principles, even in a resource-constrained setting. It is thus time to realign the values of the Chinese healthcare system based on Confucian virtues so that the patient is again the center of attention. The essay puts forward suggestions for medical professionals to discipline themselves by ensuring good professional and interpersonal skills.DOWNLOAD HISTORY | This article has been downloaded 228 times in Digital Commons before migrating into this platform.

scholarly journals 人工智能熱須降溫

2019 ◽  
Vol 17 (2) ◽  
pp. 123-126
Author(s):  
Jinzhou YE
Keyword(s):  
Medical Practice ◽  
Critical Reflection ◽  
Human Values ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Digital Commons

LANGUAGE NOTE | Document text in Chinese; abstract in English only.Robert Sparrow's critical reflection on the growing enthusiasm for applying AI to medicine is timely and deeply thought provoking. Despite AI's apparent benefits, its potential to restructure medical practice, the doctor–patient relationship and, more generally, human values in the long term give us every reason to be cautious. Before AI is fully embraced, its potential perils should be carefully considered.DOWNLOAD HISTORY | This article has been downloaded 25 times in Digital Commons before migrating into this platform.

scholarly journals 挑戰與應對——中國傳統哲學視角下ＡＩ時代的醫患關係

2019 ◽  
Vol 17 (2) ◽  
pp. 43-47
Author(s):  
Hanhui XU
Keyword(s):  
Alternative View ◽  
Patient Relationship ◽  
Foreseeable Future ◽  
Doctor Patient Relationship ◽  
Digital Commons ◽  
Confucian Thought

LANGUAGE NOTE | Document text in Chinese; abstract in English only.AI physicians may replace human physicians in the foreseeable future. This, according to some philosophers, would maximize patients’ autonomy by helping to eradicate the paternalistic model of the doctor–patient relationship. In my view, however, this trend might pose a new threat to patients’ autonomy: the domination of machines. AI physicians would become dominant, depriving patients of their autonomy. This issue cannot be appropriately addressed until an alternative view of the doctor–patient relationship is available. The Confucian perspective on this relationship may be helpful. In Confucian thought, interaction between the physician and the patient is crucial. Thus, a better model would involve doctors, patients and AI devices, with AI-based diagnosis helping doctors to serve patients as efficiently as possible.DOWNLOAD HISTORY | This article has been downloaded 22 times in Digital Commons before migrating into this platform.

scholarly journals 等著被說出的軀體與病患意義

2015 ◽  
Vol 13 (2) ◽  
pp. 41-44
Author(s):  
Hongzhong QIU
Keyword(s):  
The Body ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Clinical Model ◽  
Digital Commons ◽  
Phenomenological Perspective ◽  
The Senses

LANGUAGE NOTE | Document text in Chinese; abstract in English only.Sun’s article is a useful exploration of the body ethics model of medicine. However, a body is not the equivalent of a person—the body is waiting to utter its meaning. This commentary, which adopts a phenomenological perspective, discusses different ways of treating the body and of interrogating the senses of the body understood by patients and doctors. Divergent such senses influence the doctor-patient relationship in quite distinct ways. To establish a new clinical model, this commentary holds that we need to pay greater attention to the epistemology and methodology of somatic phenomenology, which can inspire us to understand the comprehensive significance of the body for medicine.DOWNLOAD HISTORY | This article has been downloaded 35 times in Digital Commons before migrating into this platform.

The unexpected challenges for a doctor in the remote operational military environment

2017 ◽  
Vol 103 (3) ◽  
pp. 171-174
Author(s):  
C S Swain
Keyword(s):  
Social Interaction ◽  
Medical Practice ◽  
Medical Knowledge ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Medical Confidentiality ◽  
Working Practices ◽  
The Military ◽  
The Impact

AbstractThe enclosed environment of a warship amplifies many recognised issues within medical practice, such as medical confidentiality, the conflicts within the doctor-patient relationship, and the impact of social interaction with patients, reflection on which can lead to adaptations in personal working practices within the military setting. Initial concerns about those deploying early on in their career may focus on medical knowledge and ability, but it is important to be aware of the unforeseen, multi-factorial, psychosocial and logistical challenges which are more likely to surface in the remote military environment.

scholarly journals Euthanasia and assisted dying: what is the current position and what are the key arguments informing the debate?

2018 ◽  
Vol 111 (11) ◽  
pp. 407-413 ◽  
Author(s):  
Andreas Fontalis ◽  
Efthymia Prousali ◽  
Kunal Kulkarni
Keyword(s):  
Decision Making ◽  
Legal Aspects ◽  
Hippocratic Oath ◽  
Moral Issue ◽  
Assisted Dying ◽  
Patient Relationship ◽  
Current Position ◽  
Doctor Patient Relationship ◽  
Moral Principles ◽  
Constitutional Right

Summary Assisted dying is a highly controversial moral issue incorporating both physician-assisted dying (PAD) and voluntary active euthanasia. End-of-life practices are debated in many countries, with assisted dying receiving different consideration across various jurisdictions. In this paper, we provide an analytic framework of the current position and the main arguments related to the rights and moral principles concerning assisted dying. Assisted dying proponents focus on the respect of autonomy, self-determination and forestalling suffering. On the other hand, concerns are raised regarding the interpretation of the constitutional right to life and balancing this with the premise of assisted dying, alongside the impacts of assisted dying on the doctor–patient relationship, which is fundamentally based on trust, mutual respect and the premise of ‘first do no harm’. Our review is underpinning the interpretation of constitutional rights and the Hippocratic Oath with the premise of assisted dying, alongside the impacts of assisted dying on the doctor–patient relationship. Most clinicians remain untrained in such decision making, with fears against crossing key ethical divides. Due to the increasing number of cases of assisted dying and lack of consensus, our review enables the integration of ethical and legal aspects and facilitates decision making.

The Doctor-Patient Relationship in the Practice of Medicine

1975 ◽  
Vol 6 (1-2) ◽  
pp. 183-193 ◽  
Author(s):  
Wolfram Schüffel
Keyword(s):  
Medical Practice ◽  
Case History ◽  
Clinical Implications ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Primary Physician ◽  
Practice Of Medicine ◽  
Complete Neglect ◽  
Diagnosis Therapy ◽  
The Relationship

The patient-doctor relationship is based on the principles of interaction, collecting data and integration of both interaction and data into an overall diagnosis/therapy. Patients with functional abdominal disorders are seen as representatives of today's general patients and a study of their management in present medical practice is reported, as revealed through literature. The literature reveals an almost complete neglect of interactional and integrational principles. This holds true even for psychosomatically oriented literature, which offers some crude clinical guidelines at best. Thus the primary physician gets little support from psychosomatic medicine in understanding the full meaning of the doctor-patient relationship. The clinical implications of the relationship are demonstrated through a short case history and implications for future training are described which are based on the primary physician's actual working experiences.

Cultural Collisions at the Bedside: Social Expectations and Value Triage in Medical Practice

2001 ◽  
Vol 10 (1) ◽  
pp. 7-15 ◽  
Author(s):  
RICHARD GORLIN ◽  
JAMES J. STRAIN ◽  
ROSAMOND RHODES
Keyword(s):  
Medical Care ◽  
Medical Practice ◽  
Emotional Awareness ◽  
Evoked Responses ◽  
Social Expectations ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
The Subject ◽  
The Relationship

As early as 1981 Gorlin and Zucker produced a film, A Complicating Factor: Doctors' Feelings as a Factor in Medical Care and in a 1983 paper on the subject they described one of the important epiphenomena of the encounter between doctor and patient—namely, the reaction of the physician to the patient and how this affects both the physician and the quality of the relationship. At that time they were concerned with the physicians' ability to reckon with their own reactions to patients who presented with problems or personality traits that complicated the doctor-patient relationship. Some patients were hateful or unlikable, some denied their disease state, some became unusually dependent on the physician, some were intimidating to the doctor. Their behavior evoked responses that tended to complicate the doctor-patient relationship with distancing, unusual identification, or hostility. That publication recognized and explained the problem and went on to suggest a process of achieving emotional awareness and mastery to help physicians maintain their appropriate role.

scholarly journals O exercício da escrita e da escuta como instrumentos de aprimoramento da prática clínica

2020 ◽  
Vol 4 (2) ◽  
pp. 86
Author(s):  
Daniele Santos Andrade ◽  
Liz Torres Pedreira ◽  
Vitoria Da Silva Costa Machado Milheiro ◽  
Yasmin Vidal Matos
Keyword(s):  
Medical Practice ◽  
Narrative Medicine ◽  
Human Sciences ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Medicine Today ◽  
Patient’S History ◽  
The Way

INTRODUCTION: The exercise of writing and listening contribute to medical practice in a unique way. The receipt of the patient's history is given by attentive listening that, for this, needs to be trained. Thus, writing is a primary tool in this process. Medicine today takes on an increasingly technical nature. DISCUSSION: The approach of Medicine and the human sciences, which for some, seems to be irreconcilable, gains space in Rita Charon's Narrative Medicine, through this cyclical and inexhaustible exercise of writing and listening more attentively and insightfully to the patient's behaviors of speaking or even to keep silent. As soon as one learns what was heard, writing comes as a dialogue with yourself to understand in greater depth what we have just experienced. Entering this complex storyline of the patient, through imagination, opens the way to develop empathy with the sender and opens space for the doctor to reflect on what he experiences. It is essential to have a theoretical and literary arsenal to connect with the patient's experiences and social place. CONCLUSION: Medicine isn´t science itself, so it presupposes an interpretation, which also arises from good listening and writing. In this way, these resources promote a more horizontal and less paternalistic doctor-patient relationship giving to the patient the protagonism over himself and his/her pain.

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