Beyond Medical Paternalism and Patient Autonomy: A Model of Physician Conscience for the Physician-Patient Relationship

1983 ◽  
Vol 98 (2) ◽  
pp. 243 ◽  
Author(s):  
DAVID C. THOMASMA
Keyword(s):  
Patient Autonomy ◽  
Patient Relationship ◽  
Physician Patient Relationship ◽  
Medical Paternalism ◽  
Physician Patient

scholarly journals 中國“病人自主權”的歷史演變——20 世紀80 年代之前

2018 ◽  
Vol 16 (1) ◽  
pp. 97-113
Author(s):  
Guobin CHENG
Keyword(s):  
Political Ideology ◽  
Patient Autonomy ◽  
Chinese Culture ◽  
The Political ◽  
Patient Relationship ◽  
Physician Patient Relationship ◽  
Historical Outline ◽  
Digital Commons ◽  
Medical Concepts ◽  
Physician Patient

LANGUAGE NOTE | Document text in Chinese; abstract also in English.本文簡要梳理了從帝制時代到上世紀80 年代之前中國病人自主狀況和相關社會理念的演變過程，並對其出現的特定歷史條件進行了初步分析。中國傳統的病人自主權是整合在社會禮法秩序中的病人家長制。雖然從中國近代到新中國成立初期，病人自主狀況和自主權的概念都發生了一定的變化，但因為它們幾乎都屈從於這兩個階段的社會政治運動，所以無法實現基礎倫理結構和價值觀的轉變。目前中國從西方引入的現代個人主義式的病人自主權概念，不僅與傳統的理解存在巨大差異，也與當前的醫學生活與社會制度不完全匹配。在中國解決病人權利保護的難題，不是任何一種單一化的理念引進、制度改造或者政治運動就可以實現的，我們必須把自己的思考投入到那個歷史與當下、理論與現實、中國與西方糾纏在一起的真實的世界，才有可能發現問題的癥結並找到正確的方向。This essay offers a historical outline of the evolution of patient autonomy and related social and medical concepts in China from the imperial era to the 1980s. The author contends that the idea of patient autonomy was totally absent from traditional Chinese culture, as every area of society, from family to medicine, was structured according to a distinctively paternalistic model and regulated by ritual guidelines (lifa). Although the Western medical practices that arrived in China in the 1840s somewhat altered the Chinese approach to medicine, and the physician-patient relationship was viewed in a more egalitarian manner after the establishment of “new China” in 1949, the effects of these changes were minimal due to the political ideology of the time. The author argues that taking a historical perspective on the issues of patient autonomy and the rights of patients in China will aid understanding of the current challenges facing medicine in China and suggest ways of resolving ethical dilemmas and ambiguities at both a theoretical and a practical level.DOWNLOAD HISTORY | This article has been downloaded 122 times in Digital Commons before migrating into this platform.

Simulation-Based Training of Communication and Emotional Competence for the Improvement of Physician-Patient Relationship

2006 ◽  
Author(s):  
Luigi Anolli ◽  
Fabrizia Mantovani ◽  
Alessia Agliati ◽  
Olivia Realdon ◽  
Valentino Zurloni ◽  
...  
Keyword(s):  
Emotional Competence ◽  
Patient Relationship ◽  
Physician Patient Relationship ◽  
Simulation Based ◽  
Physician Patient

Models of the Physician-Patient Relationship

JAMA ◽  
1992 ◽  
Vol 268 (11) ◽  
pp. 1411
Author(s):  
Judith Andre
Keyword(s):  
Patient Relationship ◽  
Physician Patient Relationship ◽  
Physician Patient

Prudence in Shared Decision-Making: The Missing Link between the “Technically Correct” and the “Morally Good” in Medical Decision-Making

2020 ◽  
Author(s):  
Paul Muleli Kioko ◽  
Pablo Requena Meana
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Patient Autonomy ◽  
Intellectual Ability ◽  
Medical Decision ◽  
Shared Decision ◽  
Physician Patient Relationship ◽  
Good Healing ◽  
The Right ◽  
Physician Patient

Abstract Shared Decision-Making is a widely accepted model of the physician–patient relationship providing an ethical environment in which physician beneficence and patient autonomy are respected. It acknowledges the moral responsibility of physician and patient by promoting a deliberative collaboration in which their individual expertise—complementary in nature, equal in importance—is emphasized, and personal values and preferences respected. Its goal coincides with Pellegrino and Thomasma’s proximate end of medicine, that is, a technically correct and morally good healing decision for and with a particular patient. We argue that by perfecting the intellectual ability to apprehend the complexity of clinical situations, and through a perfection of the application of the first principles of practical reason, prudence is able to point toward the right and good shared medical decision. A prudent shared medical decision is therefore always in keeping with the kind of person the physician and the patient have chosen to be.

Crisis and Informed Consent: Analysis of a Law-Medicine Malocclusion

1987 ◽  
Vol 12 (1) ◽  
pp. 55-97 ◽  
Author(s):  
Fran Carnerie
Keyword(s):  
Informed Consent ◽  
Medical Treatment ◽  
Clinical Setting ◽  
Patient Relationship ◽  
Physician Patient Relationship ◽  
Catastrophic Illness ◽  
Physician Patient ◽  
Emotional Impairment

AbstractMany individuals develop a temporary state of cognitive and emotional impairment after being diagnosed with catastrophic illness. Thus, when crucial decisions about medical treatment are required, they are unable to assimilate information; or worse, the legal need to be informed can rival a psychological desire to not be informed. The Canadian informed consent doctrine is unresponsive to crisis and clinically impracticable, and so paradoxically compromises the integrity and autonomy it was designed to protect. Many aspects of the physician-patient relationship and clinical setting also undermine the philosophical values enshrined in this doctrine. This further jeopardizes the individual's integrity. The Article explores proposals for change such as delaying the informing and consenting, improving the concept of consent, and improving the role of the physician.

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