Davidson John H
Assistant Professor of Medicine, Mayo Medical School; Consultant, Division of Executive and International Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Rambam Maimonides Med J. 2015 Apr 29;6(2):e0014. doi: 10.5041/RMMJ.10198. eCollection 2015 Apr.
The "curative potential" in almost any clinical setting depends on a caregiver establishing and maintaining an empathic connection with patients so as to achieve "narrative competence" in discerning and acting in accord with their preferences and best interests. The "narrative medicine" model of shared "close reading of literature and reflective writing" among clinicians as a means of fostering a capacity for clinical empathy has gained validation with recent empirical studies demonstrating the enhancement of theory of mind (ToM), broadly conceived as empathy, in readers of literary fiction. Talmudic legends, like that of Rabbi Judah's death, are under-appreciated, relevant sources of literary fiction for these efforts. The limitations of narrative medicine are readily counterbalanced by simultaneously practiced attention to traditional bioethical principles, including-especially-beneficence, non-maleficence, and autonomy.
在几乎任何临床环境中,“治愈潜力”都取决于护理人员与患者建立并维持共情联系,以便在识别并按照患者的偏好和最大利益行事方面实现“叙事能力”。临床医生之间共享“仔细阅读文学作品和进行反思性写作”的“叙事医学”模式,作为培养临床共情能力的一种手段,已得到近期实证研究的验证,这些研究表明,广义上被视为共情的心理理论(ToM)在文学小说读者中得到了增强。犹太法典中的传说,比如拉比·犹大之死的传说,在这些努力中是未得到充分重视却相关的文学小说来源。叙事医学的局限性很容易通过同时践行对传统生物伦理原则的关注来平衡,这些原则尤其包括行善、不伤害和自主。