Vanderpool H Y, Weiss G B
J Med Philos. 1984 Nov;9(4):353-72. doi: 10.1093/jmp/9.4.353.
Little attention has been given in medical ethics literature to issues relating to the truthfulness of patients. Beginning with an actual medical case, this paper first explores truth-telling by doctors and patients as related to two prominent models of the physician-patient relationship. Utilizing this discussion and the literature on the truthfulness and accuracy of the information patients convey to doctors, these models are then critically assessed. It is argued that the patient agency (patient autonomy or contractual) model is inherently and seriously flawed in numerous circumstances, even those involving informed and competent adult patients.
医学伦理文献中很少关注与患者真实性相关的问题。本文从一个实际医疗案例入手,首先探讨医生和患者之间的如实告知与两种突出的医患关系模式的关联。通过这一讨论以及关于患者向医生传达信息的真实性和准确性的文献,对这些模式进行批判性评估。有人认为,患者能动性(患者自主或契约)模式在许多情况下,甚至在涉及知情且有行为能力的成年患者的情况下,本身就存在严重缺陷。