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临床判断、道德焦虑与精神病学的局限

Clinical judgment, moral anxiety, and the limits of psychiatry.

作者信息

Murray Bradley

机构信息

The Psychotherapy Practice, 360 Dupont St., Toronto, ON, M5R 1V9, Canada.

出版信息

Med Health Care Philos. 2017 Dec;20(4):495-501. doi: 10.1007/s11019-017-9771-4.

Abstract

It is common for clinicians working in psychiatry and related clinical disciplines to be called on to make diagnostic clinical judgments concerning moral anxiety, which is a kind of anxiety that is closely bound up with decisions individuals face as moral agents. To make such a judgment, it is necessary to make a moral judgment. Although it has been common to acknowledge that there are ways in which moral and clinical judgment interact, this type of interaction has remained unacknowledged. This raises questions as to the nature and limits of psychiatry-particularly concerning the extent to which psychiatric discourse ought to incorporate moral discourse, and the role of the clinician as an expert in identifying problematic anxiety.

摘要

在精神病学及相关临床学科工作的临床医生,常常需要就道德焦虑做出诊断性临床判断,道德焦虑是一种与个体作为道德主体所面临的决策紧密相关的焦虑。要做出这样的判断,就必须进行道德判断。尽管人们普遍承认道德判断和临床判断存在相互作用的方式,但这种相互作用类型却一直未得到认可。这就引发了关于精神病学的性质和局限性的问题——尤其是关于精神病学论述应在多大程度上纳入道德论述,以及临床医生作为识别问题焦虑专家的角色问题。

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