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基于福柯伦理视角的扎根理论质性研究方法:临床环境中患者自主决定权的解构

Grounded theory qualitative approach from Foucault's ethical perspective: Deconstruction of patient self-determination in the clinical setting.

作者信息

Molina-Mula Jesús

机构信息

Nursing and Physiotherapy Department, University of Balearics Island, Palma 07122, Illes Balears, Spain.

出版信息

World J Clin Cases. 2021 Oct 6;9(28):8312-8326. doi: 10.12998/wjcc.v9.i28.8312.

Abstract

This paper aims to explain the construction of the autonomous subject from Foucault's ethical perspective for the qualitative analysis of interprofessional relationships, patient-professional relationships, and moral ethics critique. Foucault tried to break loose from the self, which is merely the result of a biopolitical subjectivation and constituted an interpersonal level. From this, different elements involved in the decision-making capacity of patients in a clinical setting were analysed. Firstly, the context in which decision-making occurs has been explained, distinguishing between traditional practices involved in self-care and the more modern conceptions that make certain possible transformations. Secondly, an attempt is made to explain the formation of the medicalisation of society using the transformations of what Foucault called "techniques of the self". Finally, the ethical framework for a subject's "self-creation", insisting more on the exercises of self-subjectivation, reinforcing the ethics of the self by itself, the "care of the self", has been explained. The role of the patient is understood as an autonomous subject to the extent that the clinical institution and the professionals involved comprehend how the patient's autonomy in the clinical environment is constituted. All these elements could generate grounded theory on the qualitative methodology of this phenomenon. The current ethical model based on universal principles is not useful to provide a capacity for patients decision-making, relegating to the background their opinions and beliefs. Consequently, a new ethical perspective emerges that aims to return the patient to the fundamental axis of attention.

摘要

本文旨在从福柯的伦理视角解释自主主体的构建,以便对跨专业关系、医患关系和道德伦理批判进行定性分析。福柯试图摆脱仅仅作为生物政治主体化结果且构成人际层面的自我。由此,分析了临床环境中患者决策能力所涉及的不同要素。首先,解释了决策发生的背景,区分了自我护理中涉及的传统做法和使某些转变成为可能的更现代观念。其次,尝试用福柯所称的“自我技术”的转变来解释社会医学化的形成。最后,解释了主体“自我创造”的伦理框架,更强调自我主体化的实践,通过自身强化自我伦理,即“自我关怀”。患者的角色在临床机构和相关专业人员理解患者在临床环境中的自主性如何构成的程度上被理解为自主主体。所有这些要素都可以为这一现象的定性方法生成扎根理论。当前基于普遍原则的伦理模式无助于提供患者决策能力,将他们的意见和信念置于次要地位。因此,一种新的伦理视角出现了,旨在将患者重新置于关注的基本轴线上。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ad9/8554413/3fe9a93a68ad/WJCC-9-8312-g001.jpg

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