scholarly journals 等著被說出的軀體與病患意義

Author(s):  
Hongzhong QIU

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.

Author(s):  
Hanhui XU

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.


Author(s):  
Li LIANG

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.


2005 ◽  
Vol 27 (4) ◽  
pp. 336-340 ◽  
Author(s):  
Hyong Jin Cho

OBJECTIVE: The message of the importance of a caring doctor-patient relationship is now like an old sermon which does not impact anyone's mind or action. Observing the healing practice of the old time physicians, who valued their attitudes and relationship with their patients more than the actual interventions, this paper reviews the literature on their main therapeutic device - the placebo effect - as a novel way of delivering this old sermon of medicine to contemporary doctors. DISCUSSION: There are countless historical and contemporary examples of the impressive placebo effect and although contested by some, it seems real and significant. The classic conditioning theory and the expectation theory explain reasonably well the mechanisms of the placebo effect, especially in conjunction with each other. The underlying biochemical pathway, according to the limited current knowledge, involves endorphins for pain and dopamine for Parkinson's disease. Finally, human factors such as the doctor's positive attitudes and a good doctor-patient relationship seem to be more essential than the placebo itself in eliciting the placebo effect. CONCLUSIONS: Given the body of evidence supporting the existence of significant placebo effect and the importance of the doctor-patient relationship in determining it, the human factors of the medical treatment should be emphasised in order to maximise the placebo effect and consequently the overall therapeutic effect of the healing acts.


Author(s):  
Mircea Gelu Buta

The disenchantment of the world and the understanding of the human body as a machine led to the training of physicians as mechanics, specialized in a limited field of the profession, in order to increase their competence and efficiency. The metaphor by which the body is understood as a machine gradually took hold of the public consciousness, changing the perception of society, about the role and purpose of the doctor. In this reality, the doctor-patient relationship, captive to the technical system, descends into dark and cold corners, drained by the mystery of human life. There are times when doctors, aware that their mechanistic training is not always enough to fulfil their vocation, realize that the medical act takes place on two levels: divine and human, and their unity is ensured by the love of God. The lack of this love gives way to evil, with the appearance of surprising medical failures, many of them unexplained rationally. 


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Kaihua Guo ◽  
Tao Luo ◽  
Li-Hua Zhou ◽  
Dazheng Xu ◽  
Guangming Zhong ◽  
...  

Abstract Background One of the most important objectives of modern medical education is to empower medical students to become humanistic clinicians. Human anatomy plays a crucial role in this mission by using cadavers to cause reflections on death, dying, illness, and the role of medical practitioners in humanistic care. The objective of this study was to introduce, describe, and evaluate the impact of a ceremony in honor of the body donors on ethical and humanistic attitudes of medical students. Methods We used a phenomenological research approach to explore and understand the lived experiences of the anatomy teachers as they teach anatomy in the context of humanism and ethics. A separate survey of third-year medical students was carried out to understand their perceptions of changes in themselves, respect for donors and donor families, and their relationship with patients. Data were collected in two phases: a desktop review of teaching materials followed by in-depth interviews of the main anatomy teachers followed by a self-administered, 5-item Likert scaled questionnaire given to students. Results In the present article, we describe the rituals conducted in honor of body donors at our School of Medicine. We also describe the lived experiences of anatomy teachers as they work on improving humanistic education quality through the introduction of the concept of “silent mentor” which refers to a cadaver that quietly allows medical students to learn from it. In turn, a ceremony in honor of body donors who have altruistically donated their bodies so that learning anatomy through dissection would be possible is also introduced. A survey of the impact of the ceremony in honor of body donors on medical students revealed positive responses in terms of promoting studying anatomy (3.96 Vs 3.95) as well as reflections on own death (4.44 Vs 4.35), the life of body donors (4.07 Vs 4.04), and how to humanely view future patients and their significant others (4.32 Vs 4.24) relative to those that did not attend the ceremony (5-item Likert scale). The majority of the students that attended the ceremony also indicated that it had a positive impact on their future doctor-patient relationship, thinking about the possibility of donating their body for teaching as well as about medical ethics. Most of them also think that attending the ceremony helped reduce their anxiety, fear, and disgust of seeing corpses or dissecting and 90% insisted that memorial ceremonies should continue being conducted at Zhongshan Medical School. Conclusion The combination of the anatomy component of the basic medical curriculum and gratitude ceremonies as well as activities to promote body bequeathal programs might help to accomplish the goal of cultivating high-quality medical students and professionals for the future. The long-term benefits would be a medical graduate who exudes empathy, relates well with patients and their significant others, leading to a productive doctor-patient relationship.


2020 ◽  
pp. 244-256
Author(s):  
Fabrizio Benedetti

This chapter seeks to emphasize the tight relationship between placebo effects and the doctor–patient relationship. The basic concept of defence mechanisms is that the body can protect itself from invaders, as the immune system does, and from damage, as the wound healing processes do. Complex cultural and social factors can also represent an important mechanism of defence. Within the context of body defence mechanisms and social interactions, the doctor–patient relationship represents a special case of beneficial social interaction which can be conceptualized as a true defence mechanism. The central point is that the system ‘patient–therapist’ is at work regardless of whether the therapy is effective or ineffective. Even if the therapy is totally ineffective, that is it has no specific effects, expectation of benefit (the placebo effect) may be sufficient to inhibit discomfort and eventually to influence the course of illness.


MELINTAS ◽  
2017 ◽  
Vol 32 (3) ◽  
pp. 266
Author(s):  
Yeremias Jena

The commodification of the body in health services covers a very broad study area. Contextualised in the Marxist understanding, the commodification of the body seemed to be associated with body as an economical commodity and alienating experience. This understanding has been intertwined with the commodification of the body in the health services, especially when it comes down to the practice of health care in which the patient’s body was treated merely as object for certain purposes. In the context of health care, treating the body as an object since Descartes not only bares the ethical-relational dimension of doctor-patient relationship, but also alienates the patient from her or his own body. This article argues that reducing a patient’s body to an object does not correspond to the nature and to the medical profession. In the light of Edmund D. Pellegrino and Alfred I. Tauber, two leading philosophers of medicine, the author will highlight the importance of the apprehension towards the patient as ‘persona’ as a response to the tendency.


Author(s):  
Yonghui MA

LANGUAGE NOTE | Document text in Chinese; abstract in English only.The last few years have witnessed huge growth in the capabilities and applications of AI. The applications of AI in medical and clinical settings are also expanding at an unprecedented rate. AI is expected to help solve many medical and diagnostic problems and support well-being and health; however, concerns are also growing about the potential for AI doctors to undermine the traditional doctor–patient relationship. The article by Guobin Chen et al. provides a systematic analysis of this issue, to which the current paper is a response. The target article has two main parts. First, it seeks to determine whether the "significance" and "meaning" of the doctor–patient relationship will be eroded, or even eliminated, by AI technologies. Second, it discusses the difference between the Western emphasis on autonomous agents and the Chinese "Dao of completing and perfecting oneself" (cheng-ren zhi dao), and points out that it is very important to recognize this distinction when providing an alternative Chinese approach to the relationship between the AI doctor and patient.DOWNLOAD HISTORY | This article has been downloaded 21 times in Digital Commons before migrating into this platform.


Author(s):  
Jinzhou YE

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.


2001 ◽  
Vol 120 (5) ◽  
pp. A735-A735
Author(s):  
C STREETS ◽  
J PETERS ◽  
D BRUCE ◽  
P TSAI ◽  
N BALAJI ◽  
...  

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