Corcoran Blake C, Brandt Lea, Fleming David A, Gu Chris N
Department of Family and Community Medicine, University of Missouri, Columbia, Missouri, USA.
University of Missouri, Center for Health Ethics, Columbia, Missouri, USA.
J Med Ethics. 2016 Apr;42(4):224-8. doi: 10.1136/medethics-2013-101718. Epub 2014 Jul 11.
As a medical student, I observed that different physicians had strikingly different attitudes and approaches when caring for patients. The care of one patient in particular continues to challenge my understanding of illness and moral responsibility in the practice of medicine. In this paper, I illustrate the care of this patient in order to evaluate the dominant ethics I was taught in medical school, in theory and in practice, and argue neither principlism nor the ethics of care fully captures the moral responsibility of physicians. Emphasising fidelity to the healing relationship, a core principle derived from Pellegrino's virtue theory, I conclude that this approach to clinical ethics fully explains physician responsibility. Pellegrino deconstructs the practice of medicine to clarify the moral event within the clinical encounter and offers a sufficiently useful and justified approach to patient care.
作为一名医学生,我观察到不同的医生在照顾患者时有着截然不同的态度和方法。尤其是对一位患者的护理,不断挑战着我对医学实践中疾病和道德责任的理解。在本文中,我阐述了对这位患者的护理情况,以便在理论和实践层面评估我在医学院所学的主流伦理学,并认为原则主义和关怀伦理学都无法完全涵盖医生的道德责任。我强调忠实于治疗关系,这是源自佩莱格里诺德性理论的一项核心原则,并得出结论,这种临床伦理学方法能充分解释医生的责任。佩莱格里诺解构了医学实践,以阐明临床相遇中的道德事件,并提供了一种足够有用且合理的患者护理方法。