Pediatric Department, St Jansdal Hospital, Harderwijk, The Netherlands.
North-West University, Vanderbijlpark, South Africa.
Health Care Anal. 2020 Jun;28(2):137-157. doi: 10.1007/s10728-019-00385-7.
Recent publications have argued that practical wisdom is increasingly important for medical practices, particularly in complex contexts, to stay focused on giving good care in a moral sense to each individual patient. Our empirical investigation into an ordinary medical practice was aimed at exploring whether the practice would reveal practical wisdom, or, instead, adherence to conventional frames such as guidelines, routines and the dominant professional discourse. We performed a thematic analysis both of the medical files of a complex patient and her daughter's diary. We did find practical wisdom, but only sporadically, whereas it has proved to be essential for professional care. This deficit appeared to result from several factors like: the organization of the practice; established routines; a hierarchical culture; and a traditional medical discourse. Moreover, we discerned various negative consequences. More empirical research into practical wisdom in everyday medical practices is needed for the benefit of professional and morally good care for every patient.
最近的一些出版物认为，在医疗实践中，尤其是在复杂的情况下，实践智慧越来越重要，以便在道德意义上关注每个个体患者的良好护理。我们对一种普通医疗实践的实证调查旨在探索该实践是否会揭示实践智慧，或者相反，是否坚持遵循常规框架，如指南、常规和主导的专业话语。我们对一位复杂患者的医疗档案和她女儿的日记进行了主题分析。我们确实发现了实践智慧，但只是偶尔出现，而这对于专业护理来说是必不可少的。这种缺陷似乎是由以下几个因素造成的：实践的组织；既定的常规；等级文化；以及传统的医学话语。此外，我们发现了各种负面影响。为了每个患者都能得到专业和道德上良好的护理，需要对日常医疗实践中的实践智慧进行更多的实证研究。
