Doctor – Patient Relationship in Clinical Legal – Medicine Practice

2021 ◽  
Vol 66 (Special Issue) ◽  
pp. 54-55
Author(s):  
George Cristian Curca ◽  
◽  
Iuliana Diac ◽  
Violeta Ionela Chirica ◽  
Filip Virgil Perde ◽  
...  

"Introduction. In Romania legal medicine suppose professional activities as forensic pathologist and legal doctor are facing victims that request documenting traumatic lesions if any or sexual abuses, prejudices, working capacity, malpraxis, etc. Objective. The objective of our work is to determine the special kind of doctor-patient relationship in clinical legal medicine and to analyze the ethical influences. Material and methods. More than 1500 cases of medico-legal examinations are performed in the National Institute of Legal Medicine Mina Minovici in Bucharest each year. Most of them are domestic violence requests or car accidents. Discussions. In the late 30 years (Ezechiel JE, Linda LE, JAMA 1992) found out 4 different relationship models that may be applied in medical practice; the paternalistic model (the patient accepts his doctor as his legal and moral representative), informative model (the patient expresses his autonomy), interpretative model (the doctor is a good friend in need) and the deliberative model of self-construction of the knowledge that the patient must have in order to have a voluntary decision. Conclusions. In clinical legal medicine the patient is not only a patient but a victim also. Therefore, the relationship is double folded. With his patient the legal doctor develops initially an informative model, then an interpretative model. With his victim the doctor develops initially a paternalistic approach (passive character type) or an informative one (active character type), usually an interpretative model as most highly requested (What would you do if you were I?) or the deliberative model when evaluating prejudices, etc. "

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

2019 ◽  
Vol 1 (1) ◽  
pp. 40-50
Author(s):  
Jose Luis Turabian

Psychology and sociology share a common object of study, human behaviour, but from different perspectives. Sociologists have focused on macro variables, such as social structure, education, gender, age, race, etc., while psychology has focused on micro variables such as individual personality and behaviours, beliefs, empathy, listening, etc. Despite the importance of interpersonal relationship skills, they depend on the community or social context in which communication takes place, and by themselves may have little relevance in the consultation. The purely psychological analysis of the doctor-patient relationship often leads to an idyllic vision, with the patient-centred consultation as the greatest exponent, which rarely occurs in real life. The purely sociological or community / social analysis of the doctor-patient relationship leads to a negative view of the consultation, which is always shown as problematic. But, the psychological system in the doctor-patient relationship cannot be neglected, and its study is of importance, at least as an intermediate mechanism that is created through socio-community relations. Although the same social causes are behind the doctor-patient relationship, when acting on psychological factors in the consultation, they act as an optical prism scattering socio-community relations that affect the doctor and the patient, giving rise to a beam of different colors of doctor-patient relationship. In doctor-patient relationship there is a modality of psychotherapy, where attitudes, thoughts and behaviour of the patient, can be change, as well as it can be extended on the way of understanding and therefore changing, his social context. Because of the distance between socio-community relations and the form of doctor-patient relations is growing in complex societies, under these conditions, the sociological factor gives the important place to the psychological factor. Given these difficulties of the doctor-patient relationship one may ask how general medical practice can persist with the usual model of doctor-patient relationship. Pain and the desire to relieve them are the basic reasons for the patient and the doctor, and they do not disappear due to the contradictions of the doctor-patient relationship. In this way, the confrontation between sociological and psychological vision is replaced by an alliance of both currents, and each of them takes on meaning only in the general vision.


2018 ◽  
Vol 28 (2) ◽  
pp. 567-570
Author(s):  
Radost Assenova ◽  
Levena Kireva ◽  
Gergana Foreva

Introduction: The European definition of WONCA of general practice introduces the determinant elements of person-centered care regarding four important, interrelated characteristics: continuity of care, patient "empowerment", patient-centred approach, and doctor-patient relationship. The application of person-centred care in general practice refers to the GP's ability to master the patient-centered approach when working with patients and their problems in the respective context; use the general practice consultation to develop an effective doctor–patient relationship, with respect to patient’s autonomy; communicate, set priorities and establish a partnership when solving health problems; provide long-lasting care tailored to the needs of the patient and coordinate overall patient care. This means that GPs are expected to develop their knowledge and skills to use this key competence. Aim: The aim of this study is to make a preliminary assessment of the knowledge and attitudes of general practitioners regarding person-centered care. Material and methods: The opinion of 54 GPs was investigated through an original questionnaire, including closed questions, with more than one answer. The study involved each GP who has agreed to take part in organised training in person-centered care. The results were processed through the SPSS 17.0 version using descriptive statistics. Results: The distribution of respondents according to their sex is predominantly female - 34 (62.9%). It was found that GPs investigated by us highly appreciate the patient's ability to take responsibility, noting that it is important for them to communicate and establish a partnership with the patient - 37 (68.5%). One third of the respondents 34 (62.9%) stated the need to use the GP consultation to establish an effective doctor-patient relationship. The adoption of the patient-centered approach at work is important to 24 (44.4%) GPs. Provision of long-term care has been considered by 19 (35,2%). From the possible benefits of implementing person-centered care, GPs have indicated achieving more effective health outcomes in the first place - 46 (85.2%). Conclusion: Family doctors are aware of the elements of person-centered care, but in order to validate and fully implement this competence model, targeted GP training is required.


Author(s):  
Mani Shutzberg

AbstractThe commonly occurring metaphors and models of the doctor–patient relationship can be divided into three clusters, depending on what distribution of power they represent: in the paternalist cluster, power resides with the physician; in the consumer model, power resides with the patient; in the partnership model, power is distributed equally between doctor and patient. Often, this tripartite division is accepted as an exhaustive typology of doctor–patient relationships. The main objective of this paper is to challenge this idea by introducing a fourth possibility and distribution of power, namely, the distribution in which power resides with neither doctor nor patient. This equality in powerlessness—the hallmark of “the age of bureaucratic parsimony”—is the point of departure for a qualitatively new doctor–patient relationship, which is best described in terms of solidarity between comrades. This paper specifies the characteristics of this specific type of solidarity and illustrates it with a case study of how Swedish doctors and patients interrelate in the sickness certification practice.


Sign in / Sign up

Export Citation Format

Share Document