Fuller Richard
Medical Department for the Elderly, The General Infirmary at Leeds, Leeds, UK.
J Health Organ Manag. 2004;18(2-3):155-78. doi: 10.1108/14777260410548419.
Managing risk and making decisions presents an increasing challenge to doctors as they are encouraged to adopt a partnership approach with patients to dealing with risk, within a "risk society" constructed around individuality, uncertainty, blame and responsibility. In-depth interviews, stimulated by clinical vignettes, were used to explore the key position of doctors within this risk society. Analysis, sensitised through contemporary texts, revealed unexpected findings that portrayed doctors as reflexive jugglers of risk. Discourses in this study revealed indecision and uncertainty, balanced against needs to preserve professional roles and engage patients in addressing risk, whilst preventing widespread harm and conflict. In concluding, the alternative approaches to risk with older people will suggest a more trusting and positive process that presents a real opportunity for truly sharing risk and decisions that benefit both doctor and patient.
在一个围绕个性、不确定性、责任归咎和责任构建的“风险社会”中,医生在管理风险和做出决策方面面临着越来越大的挑战,因为他们被鼓励与患者采取合作方式来应对风险。通过临床案例激发进行的深度访谈,被用于探究医生在这个风险社会中的关键地位。借助当代文献进行的敏感性分析揭示了一些意外发现,这些发现将医生描绘成风险的反思性应对者。本研究中的论述揭示了犹豫不决和不确定性,同时要在维护专业角色以及让患者参与应对风险之间取得平衡,还要防止广泛的伤害和冲突。总之,针对老年人的风险应对替代方法将意味着一个更具信任和积极意义的过程,这为真正地分担风险以及做出使医患双方都受益的决策提供了切实机会。