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以患者为中心的医学背景下的医患关系。对话伦理学的结论

[The doctor-patient relationship against the backdrop of patient-centered medicine. The conclusions of dialogical ethics].

作者信息

Kreß H

机构信息

Evangelisch-Theologische Fakultät, Abteilung für Sozialethik, Universität Bonn, Am Hof 1, 53113, Bonn, Deutschland.

出版信息

Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2012 Sep;55(9):1085-92. doi: 10.1007/s00103-012-1535-y.

Abstract

"Health" and "illness" are multilayered terms. The understanding of human health depends, apart from scientific aspects, on people's individual perceptions as well as on aspects of culture and world view. The ideal of patient-centered medicine requires that a physician does not merely have to establish an objectifiable diagnosis. Rather, a physician should also respect the patients' right to self-determination, their personal values, and their subjective view of health and illness. The philosophy of dialogue, which developed in the twentieth century, offers a conceptual background for this ideal. On an empirical basis, the successful communication between doctor and patient can be interpreted as a useful placebo phenomenon. Alternative medicine puts great emphasis on the doctor's attentive care. This also explains why the alternative branch of medicine has appealed to many patients. Therefore, science-oriented medicine should review methods in which the doctor's empathy and dialogue ability are crucial to treatment success. It is part of the physician's responsibility to appreciate the personal perspectives of patients, to respect them and, if necessary, to engage with them critically.

摘要

“健康”和“疾病”是具有多层含义的术语。对人类健康的理解,除了科学方面外,还取决于人们的个人认知以及文化和世界观等方面。以患者为中心的医学理念要求医生不仅要做出客观可查的诊断。相反,医生还应尊重患者的自主决定权、个人价值观以及他们对健康和疾病的主观看法。20世纪发展起来的对话哲学为这一理念提供了概念背景。基于实证,医生与患者之间的成功沟通可被解释为一种有益的安慰剂现象。替代医学非常强调医生的悉心照料。这也解释了为什么医学的替代分支吸引了许多患者。因此,以科学为导向的医学应该审视那些医生的同理心和对话能力对治疗成功至关重要的方法。理解患者的个人观点、尊重这些观点并在必要时进行批判性互动是医生职责的一部分。

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