Adler R H
Medizinische Abteilung, C.L. Lory-Haus, Inselspital Bern.
Schweiz Med Wochenschr. 1996 Apr 13;126(15):612-5.
Behind iatrogenic disturbances caused by psychological factors lies the dependence of present day medicine on the reductionist scientific paradigm of the 18th century. The latter excludes psychological and social factors from the "scientific equation". Only absolute objectivity and neutrality in the observer, and the avoidance of personality and history in the patient, are held to be valid. The patient's individual reality, as influencing his individual physiology, is not considered. The results are errors in diagnosis (e.g. with patients suffering from chronic pain), abuse (including sexual) of women patients, and insufficient care of cancer patients. Psychological iatrogenic disturbances can be reduced by training medical students in biopsychosocial interrelations and by self-experience courses for physicians.
心理因素导致的医源性干扰背后，是当代医学对18世纪还原论科学范式的依赖。后者将心理和社会因素排除在“科学等式”之外。只有观察者的绝对客观性和中立性，以及患者避免个性和病史被认为是有效的。患者影响其个体生理的个体现实未被考虑。结果是诊断错误（例如慢性疼痛患者）、对女性患者的虐待（包括性虐待）以及对癌症患者的护理不足。通过对医学生进行生物心理社会相互关系的培训以及为医生开设自我体验课程，可以减少心理医源性干扰。
