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从医生的故事到医生的故事,再回归原点。

From Doctors' Stories to Doctors' Stories, and Back Again.

作者信息

Childress Marcia Day

机构信息

Associate professor of medical education (medical humanities) and the David A. Harrison III Distinguished Medical Educator at the University of Virginia (UVA) School of Medicine in Charlottesville, Virginia.

出版信息

AMA J Ethics. 2017 Mar 1;19(3):272-280. doi: 10.1001/journalofethics.2017.19.3.nlit1-1703.

Abstract

Stories have always been central to medicine, but during the twentieth century bioscience all but eclipsed narrative's presence in medical practice. In Doctors' Stories, published in 1991, Kathryn Montgomery excavated medicine's narrative foundations and functions to reveal new possibilities for how to conceive and characterize medicine. Physicians' engagement with stories has since flourished, especially through the narrative medicine movement, although in the twenty-first century this has been challenged by the health care industry's business-minded and data-driven clinical systems. But doctors' stories-and Montgomery's text-remain crucial, schooling clinicians in reflection, ethical awareness, and resilience. Physicians who write even short, 55-word reflective stories can hold to humanistic and ethical understandings of patient care and of themselves as healers even as they practice in systematized settings and employ evidence-based expertise.

摘要

故事在医学中一直占据核心地位,但在20世纪,生物科学几乎使叙事在医疗实践中的存在黯然失色。在1991年出版的《医生的故事》中,凯瑟琳·蒙哥马利挖掘了医学的叙事基础和功能,以揭示构想和描述医学的新可能性。从那时起,医生对故事的参与蓬勃发展,尤其是通过叙事医学运动,尽管在21世纪,这受到了医疗行业商业思维和数据驱动的临床系统的挑战。但医生的故事以及蒙哥马利的文本仍然至关重要,它们让临床医生学会反思、培养道德意识并增强适应力。即使在系统化的环境中执业并运用循证专业知识,那些撰写哪怕只有55字的简短反思故事的医生,也能坚持对患者护理以及对自身作为治疗者的人文和道德理解。

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