Harrington John A
University of Warwick, Coventry.
Med Law. 2003;22(2):221-32.
This article analyzes the nature of clinical decision-making in order to clarify some of the impediments to the direct regulation of medical work. It develops the familiar idea of medicine as an art, showing that this includes the notion that each clinical case is unique, that clinical medical knowledge is unavoidably segmented, that clinicians commonly reason from exemplary cases, and that in this process the fine judgment of each practitioner is indispensable. Taken together this means that outside attempts to regulate medicine directly are doomed to fail. A more promising strategy would be to adopt forms of reflexive regulation which mobilize the self-regulatory capacities of medical professionals themselves.
本文分析了临床决策的本质，以厘清直接监管医疗工作的一些障碍。它进一步阐述了医学是一门艺术这一为人熟知的观点，表明这其中包括每个临床病例都是独特的这一概念、临床医学知识不可避免地存在细分、临床医生通常从典型病例进行推理，以及在此过程中每位从业者的敏锐判断不可或缺。综合起来，这意味着外部直接监管医学的尝试注定会失败。一个更有前景的策略是采用反思性监管形式，调动医学专业人员自身的自我监管能力。
