Physician-Patient Relationship: Ethical Topic in Medicine
Section A. Responsibility to Patients. Behaviour towards Patients. Failure of Communication. Personal Relationships between Doctors and Patients. Doctors engaging in behaviors that fall outside this code of conduct are said to be Doctors engage in a myriad of professional relationships both with patients of their patients before their own financial or personal interests and must act in a . A physician must terminate the patient-physician relationship before initiating a or if a romantic relationship would otherwise foreseeably harm the individual. a physician's ethical obligations to avoid inappropriate behavior, a physician.
Assertive people respect themselves and others, and observe the authority of all sides. They are both honest and frank, and do not accuse themselves or others. Their approach to matters is problem-oriented, that is, when dealing with a problem, instead of accusing themselves and others, they think of a solution. They listen effectively and speak appropriately and understandably.
During conflict they emphasize conversation. Their arguments are clear, specified, objective, fair and respectful, and eventually they are the most successful communicators. Issues such as breaking bad news, wasted treatments and medical mistakes are easy and solvable with this type of behavioral pattern. While submissiveness, dominance and aggression lead to lose-lose situations in long term, assertiveness, is a helpful behavioral pattern and finally results in win-win solutions 9.
Based on the above-mentioned notions, the following practical hints should be outlined: An important topic in aesthetics and artistic criticism that is also related to ethics is psychic distance. In aesthetics, this refers to the distance that should exist between a work of art and the viewer, so that aesthetic entente is created and art is not confused with reality. Omitting the psychic distance and forming deep sympathy and psychological identification with the work of art obstructs artistic judgment and aesthetic approach.
In medical ethics, the concept seems to be important while encountering patients. Reduction of psychic distance and excessive sympathy with patients prevent an effective doctor-patient relationship as a fundamental element of treatment.
Nonverbal communication skills are referred to as body language. This type of communication is very important in the doctor-patient relationship due to factors such as the limited visiting time, and linguistic and discourse differences. Truth-Telling versus Pain Relief: One of the oldest ethical challenges is the pain and suffering that can be caused by telling the truth. On the other hand, we can bring comfort and relief to patients by lying to them.
Physicians can employ various methods at their discretion, but it seems that health care systems are more inclined toward telling the truth, and doctors must try to maintain a balance between the two.
Unlike intelligence quotient that does not improve after the second decade of life, emotional quotient can continue to improve till the end. Emotional quotient refers to the ability to control emotions, sentiments and unwanted desires. People with high intelligence quotient dealing with people with lower intelligence quotient are susceptible to reckless, impulsive behavior and may gradually lose their EQ In order to improve the doctor-patient relationship, health providers must be instructed in techniques to promote their emotional quotient.
C The Sociological Essence of the Doctor-Patient Relationship Unlike the psychological approach, the sociological approach to the doctor-patient relationship examines the essence of this individualistic relationship in a social context.
In other words, the sociological approach regards the doctor-patient relationship beyond a merely mutual connection and therefore external elements are considered particularly important. In order to investigate this relationship from the sociological perspective, communicative actions serve as a valid basis.
They have been included among the most important sociological criteria in the last few decades as a set of social actions oriented towards reaching entente. The target of communication action theory is to subvert a single prophetic and patriarchal individualism in human interactions.
In this book Habermas distinguishes and characterizes his theory by drawing a distinction between instrumental action and communicative action.
Doctor–patient relationship - Wikipedia
By contrast, I shall speak of communicative action whenever the actions of the agents involved are coordinated not through egocentric calculations of success but through acts aiming at reaching an understanding. In communicative action the participants are not primarily oriented to their own individual successes; they pursue their individual goals under the condition that they can harmonize their plans of action on the basis of common situation definitions.
Reducing an individual to only one of the functions of his or her integrity is called instrumentalism. The function of a ticket seller in a bus station is just like that of a machine and therefore his human dimension could easily be overlooked.
In the doctor-patient relationship both sides especially the doctor are susceptible to perceive others as mere instruments. The power that is practiced over patients by "medical gazing" makes them abject by reducing them to bodies that are examined simply to locate illness. Three fundamental concepts in sociology and philosophy have been purposed to deal with instrumentalism: In his works on the Golden Rule, Kant argues that instrumental action is inconsistent with socialization and human dignity, and proposes to regard others as an acme, not an instrument.
The universal version of this rule is that you should like for others whatever you like for yourself and vice versa. In the former, a human is a mystery that unfolds and in the latter, an issue that resolves Emmanuel Levinas states, "We are responsible for each other, and me more so…" This approach considers responsibility toward others as an unconditional matter, but does not require others to be equally responsible in return. Communicative Action Communicative action is allegedly an action focused on entente.
Whoever wants to be successful in reaching entente should be prepared to bring up claims. Habermas states that the communication between a speaker and a listener is constituted by the existence of three universally valid claims: The terms of these claims in the doctor-patient relationship accurately reveal the sociological essence of this relationship.
Doctors should speak understandably and beware of ambiguity and opacity in their speech.
On the other hand, they should make true statements and propositions, scientific and other. They should be honest and have faith in what they say, and ultimately they can use their discretion to determine the content of their relationship with patients. Analysis To clarify the concept of relationship and connectedness, we used a hybrid concept analysis including: On the basis of the comparative concept analysis, the doctor-patient relationship is an interdisciplinary notion and a mono-disciplinary approach will reduce this relationship to communicative skills.
Discussion and Conclusion The doctor-patient relationship has greater impact on the health system than it may seem at first.
The doctor-patient relationship: toward a conceptual re-examination
In this paper, three novel dimensions of the doctor-patient relationship were deeply explored. The philosophical approach emphasizes the importance of promoting moral sensitivity. Communicating with others entails considerations rooted in the human soul that provoke great philosophical concerns. The psychological approach emphasizes learning about behavioral patterns, enhancing the intelligence quotient, and creating a balance between truth-telling and pain relief.
Finally, the sociological approach demonstrates that the doctor-patient relationship is part of a macro social relationship in a community and discovers various aspects beyond the two-person relationship. The re-examination of the doctor-patient relationship in this paper can have several important implications. Attention to the philosophical, sociological and psychological dimensions provides a basis to evaluate the doctor-patient relationship both quantitatively and qualitatively. Two well-known examples of such qualitative and quantitative evaluations may be seen in the development of native questionnaires and conversion of random considerations to systemic approaches.
As a final word, a re-examination of the doctor-patient relationship requires an interdisciplinary approach that should take into account the legal as well as juridical essence in addition to the three approaches discussed in this paper.
Cambridge University Press; The Phenomenology of Suffering in Medicine: Explorations in the Baltic Sea Region [dissertation]. Phenomenology and intentional acts of sensing in Brentano. Defining features of moral sensitivity and moral motivation: Social Behavior and Personality. Din Pajohy Boshra Cultural Institute; Emotional intelligence and patient-centred care.
J R Soc Med.
Doctor's Ethical Code of Conduct | francinebavay.info
McCarthy T, Habermas J. The Theory of Communicative Action: What can a physician do with a particularly frustrating patient? Physicians will sometimes encounter a patient whose needs, or demands, strain the therapeutic alliance. Many times, an honest discussion with the patient about the boundaries of the relationship will resolve such misunderstandings.
The physician can initiate a discussion by saying, "I see that you have a long list of health concerns. Unfortunately, our appointment today is only for fifteen minutes. Let's discuss your most urgent problem today and reschedule you for a longer appointment.
That way, we can be sure to address everything on your list. What do you think we could do to meet everybody's needs? And yet, physicians may not abandon patients. When the physician-patient relationship must be severed, the physician is obliged to provide the patient with resources to locate ongoing medical care.
When is it appropriate for a physician to recommend a specific course of action or override patient preferences? Under certain conditions, a physician should strongly encourage specific actions. When there is a high likelihood of harm without therapy, and treatment carries little risk, the physician should attempt, without coercion or manipulation, to persuade the patient of the harmful nature of choosing to avoid treatment.
Court orders may be invoked to override a patient's preferences. However, such disregard for the patient's right to noninterference is rarely indicated.
Court orders may have a role in the case of a minor; during pregnancy; if harm is threatened towards oneself or others; in the context of cognitive or psychological impairment; or when the patient is a sole surviving parent of dependent children.
However, the use of such compulsory powers is inherently time-limited, and often alienates the patient, making him less likely to comply once he is no longer subject to the sanctions. What is the role of confidentiality? Confidentiality provides the foundation for the physician-patient relationship. In order to make accurate diagnoses and provide optimal treatment recommendations, the physician must have relevant information about the patient's illness or injury.
This may require the discussion of sensitive information, which would be embarrassing or harmful if it were known to other persons. The promise of confidentiality permits the patient to trust that information revealed to the physician will not be further disseminated. The expectation of confidentiality derives from the public oath which the physician has taken, and from the accepted code of professional ethics.
The physician's duty to maintain confidentiality extends from respect for the patient's autonomy. Would a physician ever be justified in breaking a law requiring mandatory reporting? In general, mandatory reporting requirements supersede the obligation to protect confidentiality. While the physician has a moral obligation to obey the law, she must balance this against her responsibility to the patient.