Dissertations / Theses on the topic 'Patient confidentiality; Medical ethics'
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Tamin, Jacques. "The doctor-patient relationship, confidentiality and consent in occupational medicine : ethics and ethical guidance." Thesis, University of Manchester, 2016. https://www.research.manchester.ac.uk/portal/en/theses/the-doctorpatient-relationship-confidentiality-and-consent-in-occupational-medicine-ethics-and-ethical-guidance(586107a4-ffe5-40be-ad19-acb9d329d732).html.
Full textBond, Tim. "HIV counselling : ethical issues in an emerging professional role." Thesis, Durham University, 1998. http://etheses.dur.ac.uk/985/.
Full textFarges, Eric. "Dynamique professionnelle et transformations de l’action publique : Reformer l’organisation des soins dans les prisons françaises : les tentatives de spécialisation de la « médecine pénitentiaire » (1970-1994)." Thesis, Lyon 2, 2013. http://www.theses.fr/2013LYO20043/document.
Full textArticle 2 of French law No 94-43 of January 18, 1994, which concerns the transfer of the organization of health care in prisons from the Ministry of Justice to the public hospital service, has often been presented as a necessary public health reform considering the state of French prisons. The AIDS epidemic and the voluntary work of the Ministry of Health and the Ministry of Justice have revealed the need for what has been called a “sanitary revolution”. However, the conditions required for this reform would seem to require a dual approach: both professional and institutional, which this study will underline. Indeed, The French law of January 18, 1994 is also the reform of a profession, and of a sector of action, that is strongly criticized publicly. The reform of organization of health care in prisons underlines the failure of a strategy for a medical specialty, and is viewed by a few observers as an attempt by some practitioners to establish a particular position within the medical sector.Launched in the early sixties by the very first Doctor-inspector for prisons, Georges Fully, the assertion of specific “ health care in prison” was designed to give more legitimacy to the practitioners and therefore to allow them a greater level of autonomy from their employer, the prison administration. The specialization was designed to be an additional resource to help to put an end to the tension that the practitioners working in prison had to face, between their contract status at the Ministry of Justice and their status as general practitioners working in prisons . However, after the violent protests in prisons during the seventies, the organisation of “ health care in prisons” became for the new Doctor-inspector, Solange Troisier, a means of legitimizing the work of a discredited public service. The consecration of a specific medical practice for prisoners was also for her a means of asserting the requirements of the Code of Criminal Procedure over those of the Code of Medical Ethics. Thus the specialization of health care in prison became a means of empowerment not for the Ministry of Justice but for the medical sector.The reform of 1994 marks the failure of this attempt of medical specialization. It results from interactions between a group of practitioners defending the idea of a non-specific medical care and several militant magistrates, coming from the trade union of magistrates, working in the prison administration who were in favour of a opening-out of the penitentiary institution. The French law of January 18, 1994, highlights the accomplishment of this type of strategy and the failure to create a specialized health care in prison, the latter being then attached to a stigmatized and outdated past.The issue of this thesis is consequently to explore the sociogenesis of a reform from the dynamics which guide a professional group, on the one hand, and the evolutions which affect a public sector of action, on the other hand. We will also show that the specialization of medicine can be understood only if it is apprehended differently and subsequently cannot be reduced only to its medical dimension
Dahlstrom, Glenda. "Privacy and confidentiality of patient health information." MU has:, 2002. http://wwwlib.umi.com/cr/mo/fullcit?p3052167.
Full textFerguson, Angus H. "Should a doctor tell? : medical confidentiality in interwar England and Scotland." Thesis, University of Glasgow, 2005. http://theses.gla.ac.uk/3150/.
Full textMason, Barbara Ann Borgstede. "Ethics, privacy, and confidentiality issues related to the application of information technology in health care /." free to MU campus, to others for purchase, 1999. http://wwwlib.umi.com/cr/mo/fullcit?p9962543.
Full textMichalowski, Sabine. "Medical confidentiality in the context of crime prevention and criminal prosecution : a comparative study." Thesis, University of Sheffield, 2001. http://etheses.whiterose.ac.uk/15088/.
Full textGreen, Linda. "Patient Satisfaction Outcomes and RN Scores on the JAND." Thesis, University of Louisiana at Lafayette, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3712363.
Full textThe quality of health care in the United States is often measured by the patient’s satisfaction. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) was developed by the Center for Medicare and Medicaid Services (CMMS) along with the Agency for Healthcare Research and Quality (AHRQ) in 2002 to standardize the assessments and measures of patient satisfaction (Koch, 2014). Healthcare organizations are mandated to report their HCAHPS results to CMMS and AHRQ. Because of the significant role nurses take in the care and overall experience of hospitalized patients, this project explored RN scores on the Judgments About Nursing Decisions (JAND) instrument by Dr. Shake’ Ketefian (1984) and patient satisfaction data. The findings from the project suggest that RNs who are functioning in the post-conventional area of Kohlberg's Moral Development Theory as measured by the JAND may have an influencing effect on patient satisfaction outcomes as measured by the HCAHPS.
Reyes-Illg, Gwendolen. "Respect for Patient Autonomy in Veterinary Medicine| A Relational Approach." Thesis, Colorado State University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10640397.
Full textThis thesis considers the prospects for including respect for patient autonomy as a value in veterinary medical ethics. Chapter One considers why philosophers have traditionally denied autonomy to animals and why this is problematic; I also present contemporary accounts of animal ethics that recognize animals’ capacity for and exercise of autonomy (or something similar, such as agency) as morally important. In Chapter Two, I review veterinary medical ethics today, finding that respect for patient autonomy is undiscussed or rejected outright as irrelevant. Extrapolating mainstream medical ethics’ account of autonomy to veterinary medicine upholds this conclusion, as it would count all patients as “never-competent” and consider determining their autonomous choices impossible; thus welfare alone would be relevant. Chapter Three begins, in Part I, by describing the ways we routinely override patient autonomy in veterinary practice, both in terms of which interventions are selected and how care is delivered. I also show that some trends in the field suggest a nascent, implicit respect for patient autonomy. Part II of Chapter Three presents feminist criticisms of the mainstream approach to patient autonomy. I argue that the relational approach to autonomy advocated by such critics can be meaningfully applied in the veterinary realm. I advance an approach that conceives respect for patient autonomy in diachronic and dialogic terms, taking the patient as the foremost locus of respect. In Chapter Four, I turn to issues of practical implementation, such as interpreting what constitutes an animal’s values and concerns, and assessing the effect of positive reinforcement training on autonomy. The Conclusion offers areas for future research while refuting the objection that a simpler, expanded welfare-based approach would yield the same substantive recommendations as my account.
Broekmann, Reginald J. (Reginald John). "Power in the physician-patient relationship." Thesis, Stellenbosch : Stellenbosch University, 2000. http://hdl.handle.net/10019.1/51884.
Full textENGLISH ABSTRACT: This paper examines aspects of power within the physicianpatient relationship. The historical development of the physician-patient relationship is briefly reviewed and some of the complexities of the relationship highlighted. It is shown that, historically, there is no imperative for the physician to consider only the interests of the patient and it has always been acceptable to consider the interests of a third party, such as the State or an employer - essentially the interests of whoever is paying the physician. The classical sources of power are then considered. These sources include legitimate power, coercive power, information power, reward power, expert power, referent power, economic power, indirect power, associative power, group power, resource power and gender power. Other approaches to power are also considered such as principle-centred power as described by Covey, power relationships as explained by Foucault, the power experience as described by McClelland and an analysis of power as expounded by Morriss. The various sources of power are then considered specifically within the physician-patient relationship to determine: if this particular type of power is operative in the physicianpatient relationship, and if so if it operates primarily to the advantage of the physician or the advantage of the patient. A simple method of quantifying power is proposed. Each form of power operative in the physician-patient relationship is then considered and graphically depicted in the form of a bar chart. Each form of power is shown as a bar and bars are added to the chart to 'build up' an argument which demonstrates the extent of the power disparity between physician and patient. It is clearly demonstrated that all forms of power operate to the advantage of the physician and in those rare circumstances where the patient is able to mobilize power to his/her advantage, the physician quickly calls on other sources of power to re-establish the usual, comfortable, power distance. Forms of abuse of power are mentioned. Finally, the ethical consequences of the power disparity are briefly considered. Concern is expressed that the power disparity exists at all but this is offset by the apparent need for society to empower physicians. Conversely, consideration is given to various societal developments which are intended to disempower physicians, particularly at the level of the general practitioner. Various suggestions are made as to how the power relationships will develop in future with or without conscious effort by the profession to change the relationship.
AFRIKAANSE OPSOMMING: Hierdie voordrag ondersoek aspekte van mag in die verwantskap tussen pasiënt en geneesheer. Die historiese ontwikkeling van die verwantskap word kortliks hersien en 'n kort beskrywing van die ingewikkeldheid van die verwantskap word uitgelig. Vanuit 'n historiese oogpunt, word 'n geneesheer nie verplig om alleenlik na die belange van die pasiënt om te sien nie en was dit nog altyd aanvaarbaar om die belange van 'n derde party soos die Staat of 'n werkgewer se belange to oorweeg - hoofsaaklik die belange van wie ookal die geneesheer moet betaal. Die tradisionele bronne van mag word oorweeg. Hierdie bronne sluit in: wetlike mag of 'gesag', die mag om te kan dwing, inligtingsmag, vergoedingsmag, deskundigheidsmag, verwysingsmag, ekonomiesemag, indirektemag, vereeningingsmag, groepsmag, bronnemag en gelslagsmag. Alternatiewe benaderings word ook voorgelê, naamlik die beginsel van etiese mag soos deur Covey beskryf, krag in menslike verhoudings soos deur Foucault, die ondervinding van krag soos beskryf deur McClelland en 'n ontleding van krag soos deur Morriss verduidelik. Hierdie verskillende mag/gesagsbronne word spesifiek met betrekking tot die geneesheer-pasiënt verhouding uiteengesit om te besluit: of hierdie tipe mag aktief is tussen geneesheer en pasiënt, en indien wel, werk dit tot die voordeel van die geneesheer of die pasiënt. 'n Eenvoudige sisteem vir die meting van mag/gesag word voorgestel. Die bronne word individueeloorweeg en gemeet en die resultaat in 'n grafiese voorstelling voorgelê op so 'n wyse dat 'n argument daardeur 'opgebou' word om die verskille van van mag/gesag tussen geneesheer en pasiënt uit te wys. Dit word duidelik uiteengesit dat alle vorms van mag/gesag ten gunste van die geneesheer werk. Kommer is getoon dat hierdie magsverskil werklik bestaan, asook die snaakse teenstelling dat die gemeenskap wil eintlik die geneesheer in "n magsposiesie plaas. Die etiese gevolge van hierdie ongebalanseerde verwantskap, asook die moontlikheid van wangebruik van hierdie mag word ook genoem. Verskillende gemeenskaplike ontwikkelinge wat die mag van die geneesheer wil wegneem word geidentifiseer, meestalop die vlak van die algmene praktisyn. Verskeie voorstelle vir toekomstige ontwikkeling van die verwantskap word voorgelê, met of sonder spesifieke pogings van die professie om die verwantskap te verbeter.
Waring, Duff William Ramus. "Medical benefit and the human lottery an egalitarian approach to patient selection /." Dordrecht ; Norwell, Mass. : Springer, 2004. http://site.ebrary.com/id/10221758.
Full textPapoutsi, Chrysanthi. "Reconfiguring privacy and confidentiality practices : a case study of technological integration in HIV health services." Thesis, University of Oxford, 2013. http://ora.ox.ac.uk/objects/uuid:265ff900-72cd-4ec7-bc95-8717d9640240.
Full textBeaty-Edwards, Dawn Tanesha. "ETHICS AT THE BEDSIDE: ADVOCACY FOR THE PATIENT AND THE COST." Master's thesis, Temple University Libraries, 2019. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/563468.
Full textM.A.
As a healthcare professional at the bedside, it has been very difficult to advocate for the patient while all parties involved cannot respect what the patient wants. Four out of five Americans do not have an advance directive. The history and court cases that have led the country to make patient’s right to make their own healthcare decisions has been decades in the making, yet still bring daily challenges within the healthcare system. When a patient’s wishes are not being honored, medical futility may lead to moral distress and compassion fatigue. Institutions provide multidisciplinary teams to address these issues, but if a patient’s capacity or competence is in question, their voice may not be heard. The toll on the healthcare provider and the patient can be permanently damaging, causing many nurses to leave the profession all together. I will attempt to determine the barriers to implementing the patient’s wishes, address the syndrome of moral distress among healthcare professionals, and attempt to offer solutions to promote well rounded, patient-centered care.
Temple University--Theses
Anthony, John. "The justfiable limitations of patient autonomy in contemporary South African medical practice." Thesis, Stellenbosch : University of Stellenbosch, 2009. http://hdl.handle.net/10019.1/2859.
Full textABSTRACT: The European Enlightenment secured man’s freedom from doctrinal thought. Scientific progress and technological innovation flourished in the 18th Century, radically changing the lives of all. Man’s mastery and transformation of his environment was matched by revolutionary political reform, resulting in the dissolution of empire and the transfer of power into the hands of the people. Social transformation saw the city-states of pre-modern man supplanted by a globalized community whose existence grew from time and space distantiation facilitated by the new technologies and the development of symbolic forms. These sweeping social, political and ideological changes of the 18th Century fostered the belief that man’s transformative authority was indeed his to command. Man believed he had a right to self-governance and to autonomous decision-making. Kant described moral autonomy as the freedom men have to show rational accountability for their actions and he saw in men a dignity beyond all price because of this moral autonomy. Personal autonomy is seen as the expression of the free will of individuals and is justifiably constrained by the need to respect the interests and agency of others. The principle of autonomy, in the context of medical practice, was not clearly articulated until the early 20th century. Prior to this, the ethical practice of medicine relied upon the beneficent intentions of the practitioners. The limits to patient autonomy have been delineated largely by issues of social justice based upon the need to share scarce resources fairly among members of society. However, autonomy remains a dominant principle and is most clearly exemplified by the process of informed consent obtained prior to any medical intervention. This thesis provides a conceptual analysis of autonomy in the context of informed consent. Following this, several different clinical scenarios are examined for evidence of justifiable limitations to patient autonomy. Each scenario is examined in the light of different moral theories including deontology, utilitarianism, communitarianism and principlist ethical reasoning. Kantian ethical reasoning is found to be resilient in rejecting any limitation to the autonomy principle whereas each of the other theories allow greater scope for morally-justified curtailment of individual autonomy. The thesis concludes with reflection on post-modern society in which the radicalization of what began with the European Enlightenment sees the transformation of pre-modern society into a global community in which epistemological certainty is no longer available. In this environment, the emerging emphasis on global responsibility requires ethical accountability, not only when individuals secure transactions between one another but also between individuals and unknown communities of men and women of current and future generations. The thesis concludes that patient autonomy is justifiably limited in South African medical practice because of issues related to social justice but that the impact of the new genetic technologies and post-modernity itself may in future set new limits to individual patient autonomy.
OPSOMMING: Die Europese Verligting het die mensdom bevry van verstarde, dogmatiese denke. Wetenskaplike en tegnologiese ontwikkelinge het tydens the 18de Eeu die lewens van almal radikaal verander. Die mens se bemeestering en transformasie van sy omgewing het gepaard gegaan met revolusionêre politieke hervormings wat gelei het tot die ontbinding van tradisionele politieke ryke en die oordrag van mag aan die mens. Sosiale transformasie het veroorsaak dat die politieke ordeninge van voor-moderne mense deur ‘n globale gemeenskap vervang is wat ontstaan het as gevolg van onder meer die ontkoppeling van tyd en plek (Giddens), en wat deur nuwe tegnologiese ontwikkelings en die ontstaan van simboliese vorms moontlik gemaak is. Hierdie uitgebreide ontwikkelinge het die idee laat ontstaan dat niks vir die 18de Eeuse mens onmoontlik is nie. Die mens het geglo dat hy ‘n reg het op self-bestuur en outonome besluite. Kant het die morele outonomie van die mens beskou as sy vryheid om verantwoordlikheid te neem vir sy eie rasioneel-begronde handelinge en verder het hy ‘n besondere waardigheid in die mens geïdentifiseer vanweë sy morele outonomie. Omdat ‘n mens hierdie eienskap besit, beskik hy oor ‘n hoër waardigheid as alle alle ander lewensvorme. Persoonlike outonomie is die uitoefenimg van die vrye wil van die individu en word om geregverdigde redes beperk deur die regte van ander mense. Die beginsel van outonomie met verwysing na mediese etiek het nie voor die begin van die 20ste eeu prominent geword nie. Voor hierdie tyd het mediese etiek staatgemaak op die goeie voorneme van die praktisyn. Die grense van individuele outonomie word nou bepaal deur die noodsaak van sosiale geregtigheid. Al is dit die geval, bly die beginsel van outonomie die belangrikste beginsel in die etiese debat en word meestal gesien as ‘n deel van die proses van ingeligte toestemming. Hierdie tesis verskaf ‘n omvattende ontleding van outonomie met betrekking tot ingeligte toestemming. Daarna word verskillende kliniese gevalle beskryf en ontleed, en verskeie etiese teorieë gebruik om die wyse waarop pasiënt outonomie reverdigbaar ingekort behoort te word, te bespreek. Die teorie van Kant is in staat om enige inkorting van outonomie in alle gevalle the weerstaan. Elkeen van die ander teorieë verskaf redes waarom die outonomie van individuele pasiënte legitiem ingekort mag word. Hierdie werk sluit af met besinning oor die post-moderne gemeenskap wat ‘n globale samelewing moet aanvaar sowel as die ontoereikenheid van enige kenteoretiese sekerheid. Die ontwikkelende verantwoordelikheid vir die totale mensdom in hierdie wêreld veroorsaak dat individue nie meer slegs moet besluit oor die morele verhouding met sy medemens nie, maar ook oor sy verhouding met mense van gemeenskappe wat geskei is in tyd en ruimte, insluitend sy verhouding met die mense van toekomstige generasies. Hierdie werk sluit af met die gevolgtrekking dat pasiënt outonomie regverdigbaar beperk word in die Suid Afrikaanse mediese praktyk deur die noodsaaklikheid van sosiale geregtigheid. Die verwagte impak van nuwe genetiese tegnologieë en die ontwikkeling van ‘n post-moderne gemeenskap mag nuwe beperkings bring vir pasiënt outonomie.
Wytiaz, Victoria. "Physician-as-patient literature: Introducing and fostering a culture of empathy in medicine." Master's thesis, Temple University Libraries, 2017. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/449267.
Full textM.A.
The physician-patient dichotomy is reinforced continuously in medical education and medical practice. The physician possesses knowledge that will be used to help the patient in some way. However, as human beings, physicians are subject to the illnesses and diseases that affect their patients. Physicians moved by this role-reversal may feel compelled to record their experiences, leading to an accumulation of “physician-as-patient literature.” Five examples of “physician-as-patient” literature illustrate five fundamental lessons that can be adapted by physicians: relating to patient vulnerability, fostering hope for patients, mobilizing support systems, recognizing physical consequences of disease, and appreciating patient quality of life. By generalizing these individual stories, it is not necessary for physicians to experience the exact disease or illness they treat. Rather, they can draw from their unique life experiences to practice empathy. The concept of empathetic medicine can be introduced in medical school training by integrating empathy education into scientific curriculum. Current practitioners can benefit from narrative exercises, reflection and physician self-disclosure in efforts to promote empathy. Medical practice requires solid relationships between human beings, physicians and patients. This basic principle is further emphasized in “physician-as-patient” literature and concerted efforts by institutions and individual physicians can lead to a foundation for a culture of empathy.
Temple University--Theses
Shannon, Sarah Elizabeth. "Caring for the critically-ill patient receiving life-sustaining therapy : combining descriptive and normative research in ethics /." Thesis, Connect to this title online; UW restricted, 1992. http://hdl.handle.net/1773/7329.
Full textOparaji, Alexander Obinna. "Hospitals Without Consulting Rooms : An Ethical Assessment of Physician-Patient Relationshop in Medical Internet." Thesis, Linköping University, Centre for Applied Ethics, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-6711.
Full textThe physician -patient relationship is fundamental to medical and healthcare practice. It is value laden. The practice of medicine and healthcare in the traditional sense accentuates a fecund doctor-patient communication. This is considered a necessary step for a proper diagnosis towards an attendant fruitful prognosis. Such a practise eventuates in the recognition of core values within the ambience of a standard medical practise. The values in question refer to issues of commitment and trust, obligations to standard care giving and reception, confidentiality, autonomy, beneficence, non maleficence, justice as well as responsibility. However, the practise of medicine today is criss-crossed by an amazing cast of transformations with the advent of the internet in the medical arena. Medical encounters take place online between doctors and patients even in the absence of pre-existing medical relationships in the hospitals.
There is today treatments and medical care mediated by the internet, a case of diagnosis and prognosis across distance, and indeed super highway medicine. This instance of hospitals without consulting rooms is morally problematic.
By the characterization of physician-patient relationship ( especially in the absence of pre-existing relationship) on the internet as virtual, unique, new and problematic, this work assesses the risks associated with such encounters in the light of ethical principles and their implications for moral responsibility.
Horowitz, Jodie. "Negotiating the Credibility of Chronic Lyme Disease: Patient Participation in Biomedical Knowledge-Creation." Scholarship @ Claremont, 2019. https://scholarship.claremont.edu/scripps_theses/1230.
Full textJohnston, Sharon 1972. "Double agent dilemma : the Canadian physician: patient advocate and social agent." Thesis, McGill University, 1999. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=30308.
Full textWeiss, Dorothea. "PRIMUM NON NOCERE : Medicine's Culture of Dealing with and Denial of the Occurrence of Medical Harm." Thesis, Linköpings universitet, Centrum för tillämpad etik, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-154396.
Full textKrapf, Elizabeth Maria. "Euthanasia, the Ethics of Patient Care and the Language of Propaganda." PDXScholar, 2012. https://pdxscholar.library.pdx.edu/open_access_etds/606.
Full textNordick, Christina L. "The ethical dilemma surrounding artificial nutrition and hydration of the persistent vegetative state patient." Theological Research Exchange Network (TREN), 1997. http://www.tren.com.
Full textGobbetti, Gisele Joana. ""A função da confidencialidade: bioética e incesto"." Universidade de São Paulo, 2006. http://www.teses.usp.br/teses/disponiveis/5/5160/tde-11102006-104710/.
Full textThis work intends to build up considerations about the confidentiality function for health professionals who deal with people involved in cases of incest, trying to evaluate the ethical limits of these interventions. The methodology used was a theoretical reflection based on Bioethics and Psychoanalyses and was illustrated by research with health professionals, including doctors, nurses, social workers and nurse assistants from Pediatric Emergency Room at University Hospital of São Paulo University. Free exploring interviews about the possibility of attending children and adolescents with suspects of sexual abuse and the way to deal professionally with such situation were conducted with those professionals. The interviews were recorded and transcribed for analysis through content analysis technique. The attendance of patients involved in sexual abuse situations is considered by health professionals as a difficult problem to approach. The absence of conflict between breaking professional secrecy and the maintenance of the reliance bond between the health professional and the patient on incest situations, shows the difficulties for the professionals to deal with people involved in those cases and, to discriminate the function of a health professional, by considering incest as a structuralizing taboo from the essence of human being.
Butson, Melissa B. "Implications of Pleiotropy for Clinical Genetic Testing: Assessing the Patient Perspective." Case Western Reserve University School of Graduate Studies / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=case1333112935.
Full textKirchner, Emily. "Presumptive Fertility and Fetoconsciousness: The Ideological Formation of 'The Female Patient of Reproductive Age'." Master's thesis, Temple University Libraries, 2017. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/435125.
Full textM.A.
Presumptive fertility is an ideology that leads us to treat not only pregnant women, but all female patients of reproductive age, with the presumption that they could be pregnant. This preoccupation with the possibility that a woman could be pregnant compels medical and social interventions that have adverse consequences on women’s lived experiences. It is important to pause now to examine this ideology. Despite our social realities -- there is a patient centered care movement in medical practice, American women are delaying and forgoing childbearing, abortion is safe and legal -- there is still a powerful medical and social process that subjugates womens’ bodies and lived experiences to their potential of being a mother. Fetoconsciousness, preoccupation with the fetus or hypothetical, not-yet-conceived, fetus privileges its potential embodiment over its mother’s reality. As a set of values that influence our beliefs, attitudes, and behaviors, the ideology of presumptive fertility is contextualized, critiqued, and challenged.
Temple University--Theses
Patterson, Spencer D. "Putting on White Coats: Professional Socialization of Medical Students Through Narrative Pedagogy in Standardized Patient Labs." Ohio University / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1339729044.
Full textLucki, Joseph Max. "Examining the Impact of Health Literacy on Communication: A Quantitative and Qualitative Analysis of a Previously Under-Studied Patient Population." Master's thesis, Temple University Libraries, 2017. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/437487.
Full textM.A.
Low health literacy is highly prevalent in the United States and can significantly impact health outcomes for patients. Prior research has shown that communication is a major mediator between health literacy and health outcomes. However, there has been limited investigation into the quality of communication of patients who attend clinics staffed by medical residents. The patient population attending the resident clinic at Temple University Hospital is made up mostly of African Americans from lower-income neighborhoods of North Philadelphia. This investigation aims to gather data regarding the relationship between health literacy and communication in this previously under-studied patient population. Using a rapidly self-administered health literacy screening tool, the quantitative data reveals a high prevalence of low health literacy in this patient population. Additionally, using a semi-structured interview with a two-staged coding process, the qualitative data describes several ways in which limited health literacy can diminish optimal patient-provider communication. The patients in this study population express a high desire for information about their health status, as incomplete communication was a potential source of anxiety. Suggestions from patients in this population focus on increasing active participation in clinic visits. Study subjects agreed that interventions targeted towards medical residents would help to improve communication with low health literacy patients. Novel approaches to educating medical trainees about health literacy should be investigated in the future.
Temple University--Theses
Kruger, Johannes Petrus 1958. "Die opskorting van pasiëntvertroulikheid in Aptekerswese: 'n etiese analise / Johann (J.P.) Kruger." Thesis, North-West University, 2012. http://hdl.handle.net/10394/8757.
Full textThesis (MPhil)--North-West University, Potchefstroom Campus, 2013
Hirvonen, Hanna. "An ethical analysis of ADHD patient experiences on diagnostics and pharmacological treatment : a scoping review." Thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-77056.
Full textKruszewski, Zita. "The use of patient-derived tissue in biomedical research." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape11/PQDD_0006/MQ43899.pdf.
Full textMcLoughlin, Pamela Ann, of Western Sydney Hawkesbury University, and School of Social Ecology. "Have you been walking?: a search for rehabilitation." THESIS_XXXX_SEL_McLoughlin_P.xml, 1994. http://handle.uws.edu.au:8081/1959.7/820.
Full textMaster of Science (Hons) Social Ecology
Moulin, Cécile. "La recherche d'un équilibre entre le droit à l'information de la parentèle et le droit au secret du patient au gré de l'évolution de la médecine génétique." Thesis, Aix-Marseille, 2018. http://www.theses.fr/2018AIXM0775.
Full textThe recent attraction of the French authorities for the development of the genetic medicine drew our attention. The establishment of the project "France genomic 2025” tends to place the genetic medicine in the center of the medical services. However, it engenders complex ethical and legal questions. The interest of the relatives to be informed in case of a serious risk for their health have raised wide debates. The protection of the health of these third parties in the patient—physician relationship enters in conflict with the patient’s right of confidentiality. French authorities were among the first to try to create a balance between those two interests. The objective of this analysis will be to identify the difficulties met by the parliament and to propose solutions to advance the French law in its research of creation of a just balance between the rights of the patients and the allies. This joint study of the French and foreign rights will lead us to propose the creation of a new tool of balance in the service of the public health
Pierce, Lynn Margaret. "Physicians who write about talking with patients : the interview." Thesis, McGill University, 1992. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=56935.
Full textQualtere-Burcher, Paul 1963. "Re-thinking the Doctor-Patient Relationship: A Physician’s Philosophical Perspective." Thesis, University of Oregon, 2011. http://hdl.handle.net/1794/12146.
Full textThe principle of respect for autonomy has been the center of gravity for the doctor-patient relationship for forty years, replacing the previous defining concept of physician paternalism. In this work, I seek to displace respect for patient autonomy with narrative and phronesis as the skills that must be mastered by the physician to engender a successful therapeutic clinical relationship. Chapter I reviews the current state of affairs in the philosophy of medicine and the doctor-patient relationship and explains how and why autonomy has become so central to physicians' understanding of how to conduct a clinical encounter with a patient. Chapter II argues that "respect for autonomy," while remaining a valid rule to be considered in some clinical relationships, cannot be the central concept that defines the relationship both because it fails to describe accurately human selfhood and also because it empirically lacks universal applicability--many humans, and most seriously ill patients, actually lack autonomy. Shared decision making, an autonomy-based model of the doctor-patient relationship, suffers from this critique of autonomy as well as its own shortcomings in that it maintains a strict fact/value distinction that is untenable. Chapter III introduces narrative philosophy and its extrapolation, narrative medicine, as a possible alternative to an autonomy model of care. I defend a narrative view of selfhood, while recognizing that even if we are in some sense narratively constituted, this still leaves many questions regarding the relationship between story and self, particularly in a clinical encounter. In Chapter IV, I seek to limit the claims of narrative by arguing that story and self can never be fully equated and that narrative must be understood as demonstrating alterity rather than eliminating it. In Chapter V, a new conception of the physician's role in the doctor-patient relationship is presented, combining phronesis, or practical wisdom, with narrative skill in four aspects of the clinical encounter: diagnosis, treatment, assistance in medical decision making, and emotional support of the patient.
Committee in charge: Naomi Zack， Chairperson； Cheyney Ryan， Member； Mark Johnson， Member； Mary Wood， Outside Member
Bigney, Mark W. "Neither mechanic nor high priest : moral suasion and the physician-patient relationship." Thesis, McGill University, 2006. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=99576.
Full textOne feature that varies within competing conceptions of medical shared decision-making is how a patient's values are to be engaged by a physician. One detail that can be overlooked under "shared" decision-making is whether or not a physician ought (or be allowed) to attempt to persuade the patient to adopt particular health-related values. Some argue that it is incumbent on a physician to share her privileged understanding of medicine so as to help her patient embrace "better" values. This thesis argues that it is dangerous to patient autonomy for a physician to exert moral suasion on her patient to attempt to influence or change those values; the danger lies in the power imbalance between patients and physicians that seems inherent in medical encounters, and is exacerbated by the sick role. Thus, while a physician ought to help her patient articulate his health-related values, she ought not try to change them.
Le, Roux-Kemp Andra. "A legal perspective on the power imbalances in the doctor-patient relationship." Thesis, Stellenbosch : University of Stellenbosch, 2010. http://hdl.handle.net/10019.1/1330.
Full textENGLISH ABSTRACT: The unique and intimate relationship that exists between a medical practitioner and his/her client is possibly one of the most important relationships that can come into being between any two people. This relationship is characterised and influenced by the qualities and attributes specific to the nature and historical development of medical care, as well as medical science in general. The doctor-patient relationship is also influenced by the social dynamics of a particular community, environmental factors, technological advances and the general social and commercial evolution of the human race. With regard to medical care and health service delivery, the doctor-patient relationship is furthermore vital to the quality of the care provided, as well as to the outcomes and relative success of the specific medical intervention or treatment. One of the distinct characteristics of the doctor-patient relationship is the power imbalance inherent in this relationship. The medical practitioner has expert knowledge and skill, while the patient finds himself or herself in an unusually dependent and vulnerable position. It is because of this important role that the doctor-patient relationship still plays in health service delivery today; the susceptibility of the relationship to a variety of influences, and the characteristic power imbalances inherent in this relationship, that a study of the doctor-patient relationship in South African medical- and health law is necessary. The characteristic power imbalances will be considered from a legal perspective in this dissertation. This study provides a comprehensive source of the doctor-patient relationship from a legal perspective. Where relevant, references are made to theories and principles from other disciplines, including sociology, economy and medical ethnomethodology. The prevalence and consequences of power imbalances in the doctor-patient relationship are identified and discussed with the aim of bringing these to the attention of both the legal fraternity, and medical practitioners. Specific problem areas are identified and solutions are offered, including the following: • The adverse consequences of power imbalances inherent in the doctor-patient relationship on the medical decision-making process are considered from various perspectives. With regard to these adverse consequences, the doctrine of informed consent is analysed and evaluated in great detail. • The influence of paternalistic notions in health service delivery; the business model of health service delivery and the effects of managed care and consumer-directed health care on the doctor-patient relationship and health service delivery in general are also analysed from a legal perspective, and specifically with regard to the power imbalances inherent in this relationship. • The role of autonomy, self-determination and dignity, as well as the principles of beneficence in medical practice, are reconsidered in an attempt to provide a solution for redressing the power imbalances inherent in the doctor-patient relationship. • The fiduciary nature of the doctor-patient relationship and the special role of trust in the relationship are emphasised throughout the dissertation as the focal point of departure in the doctor-patient relationship and the main constituent in any legal endeavor to redress the power imbalances inherent in it.
AFRIKAANS OPSOMMING: Die unieke en intieme verhouding wat bestaan tussen ‘n mediese praktisyn en ‘n pasiënt is wêreldwyd waarskynlik een van die belangrikste verhoudings wat tussen twee persone tot stand kan kom. Hierdie verhouding word gekenmerk en beïnvloed deur kwaliteite en eienskappe eie aan die besonderse aard en historiese ontwikkeling van gesondheidsorg, sowel as die mediese wetenskap in die algemeen. Die dokter-pasiënt verhouding word verder beïnvloed deur die sosiale dinamika van ‘n bepaalde gemeenskap, omgewingsfaktore, tegnologiese vooruitgang en die algemene sosiale en kommersiële ontwikkeling van die mensdom. Op die terrein van gesondheidsorg en mediese dienslewering is die dokter-pasiënt verhouding voorts ook sentraal tot die kwaliteit van die mediese sorg wat verskaf word, sowel as die uitkomste en relatiewe sukses van die spesifieke mediese behandeling. Een van die kenmerkende eienskappe van die dokter-pasiënt verhouding is die magswanbalans wat daar tussen dokter en pasiënt bestaan. Die mediese praktisyn beskik oor deskundige kennis en vaardighede, terwyl die pasiënt hom- of haarself in ‘n ongewone, afhanklike en kwesbare posisie bevind. Dit is dan veral weens die besondere rol wat hierdie verhouding steeds in hedendaagse gesondheidsorg speel, die beïnvloedbaarheid van hierdie verhouding deur ‘n verskeidenheid faktore, sowel as die kenmerkende magswanbalans inherent in die verhouding, dat ‘n ondersoek na die dokter-pasiënt verhouding in die Suid-Afrikaanse mediese reg noodsaaklik is. Hierdie kenmerkende magswanbalans sal vanuit ‘n regsperspektief verder in hierdie proefskrif ondersoek word. Hierdie studie bied ‘n omvattende bron van die dokter-pasiënt verhouding benader vanuit ‘n regsperspektief, terwyl verwysings na teorieë en beginsels van ander dissiplines soos die sosiologie, ekonomie en mediese etnometodologie ook waar nodig ingesluit word. Die voorkoms en gevolge van ‘n magswanbalans in die dokter-pasiënt verhouding word verder geïdentifiseer en bespreek ten einde dit onder die aandag te bring van beide regslui en medici. Spesifieke probleemareas wat geïdentifiseer is en die oplossings wat daarvoor aan die hand gedoen is sluit die volgende in: • Die nadelige gevolge van die bestaan van ‘n magswanbalans in die dokter-pasiënt verhouding op die mediese-besluitnemingsproses word bespreek vanuit verskillende persepktiewe. Met betrekking tot hierdie nadelige gevolge, word die leerstuk van ingeligte toestemming in besonder geanaliseer en geëvalueer. • Die invloed van ‘n paternalistiese benadering tot gesondheidsorg, die besigheids-model van gesondheidsorg, en die effek van bestuurde- en verbruikersgedrewe gesondheidsorg inisiatiewe op die dokter-pasiënt verhouding en die verskaffing van gesondheidsdienste in die algemeen word ook vanuit ‘n regsperspektief ge-analiseer. Spesifieke aandag word in dié verband gegee aan die invloede van hierdie benaderings en perspektiewe op die magswanbalans inherent aan die dokter-pasiënt verhouding. • Die besondere rol van autonomie, selfbeskikking en menswaardigheid, asook die beginsels van weldadigheid in gesondheidsorg, word heroorweeg in ‘n poging om ‘n meer gelyke distribusie van mag in die dokter-pasiënt verhouding te verseker. • Die fidusiêre aard van die dokter-pasiënt verhouding en die besondere rol wat vertroue in hierdie verhouding speel, word in hierdie proefskrif beklemtoon en word voorts as die basis van die dokter-pasiënt verhouding beskou. Vertroue, as ‘n kenmerk van die dokter-pasiënt verhouding, behoort ook die fokuspunt te wees van enige poging om die magswanbalans in die dokter-pasiënt verhouding aan te spreek.
Rogers, Joanna. ""Agency and language in the clinical setting"." Thesis, McGill University, 1989. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=59377.
Full textThe role and function of language and its relationship to the ascription of human agency in the clinical setting is discussed. A patient's understanding and interpretation of the meaning of illness or disease requires a dialogue between patient and care giver such that the patient's agential horizons are incorporated into the decision-making process. A review is called for, therefore, of the dominance given to the technological over the human agential dimensions of decision-making in the health care environment.
Carmack, Heather J. "How to Say I'm Sorry: A Study of the Veterans Administration Hospital Association's Apology and Disclosure Program." Ohio : Ohio University, 2008. http://www.ohiolink.edu/etd/view.cgi?ohiou1209039528.
Full textKeevy, Daniel Matthew John. "A critical analysis of the doctor-patient relationship in context of the right to adequate health care." Diss., University of Pretoria, 2012. http://hdl.handle.net/2263/25086.
Full textDissertation (LLM)--University of Pretoria, 2012.
Public Law
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Oscarsson, Victoria. "The Relationship between Paternalism and Autonomy in Medicine from an Ethical and Legal Viewpoint." Thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-87104.
Full textM’boge, Fredriksson Lucille A., and Angelika Torbjörnsson. "När ett Jehovas vittne avsäger sig blodtransfusion : Etiska problem som kan uppstå hos vårdaren vid en livsavgörande situation." Thesis, Högskolan i Borås, Institutionen för Vårdvetenskap, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-20554.
Full textProgram: Sjuksköterskeutbildning
Shackelford, Katya A. "Complexities of Participation: Education and Authority in Primary Care Patient-Provider Interactions in the age of the Internet." Scholarship @ Claremont, 2012. http://scholarship.claremont.edu/scripps_theses/72.
Full textSidler, Daniel. "Medical futility as an action guide in neonatal end-of-life decisions." Thesis, Stellenbosch : Stellenbosch University, 2004. http://hdl.handle.net/10019.1/50017.
Full textENGLISH ABSTRACT: This thesis discusses the value of medical futility as an action guide for neonatal endof- life decisions. The concept is contextualized within the narrative of medical progress, the uncertainty of medical prognostication and the difficulty of just resource allocation, within the unique African situation where children are worse off today than they were at the beginning of the last century. parties actively engage in an interactive deliberation for a plan of action. Both parties ought to accept moral responsibility. Such a model of deliberation has the added advantage of transcending the limitations of the participants to arrive at a higher-level solution, which is considered more than just a consensus. It has been argued that medical progress has obscured the basic need for human compassion for the dying and for their loved ones. The literature furthermore reports that the quality of end-of-life care is unsatisfactory for both patients and their families. It is within this context that the concept of medical futility is positioned as a useful action guide. As we do not have the luxury of withdrawing from the responsibility to engage in the deliberation of end-of-life decisions, such responsibility demands an increasing awareness of ethical dilemmas and a model of medical training where communication, conflict-resolution, inclusive history taking, with assessment of patient values and preferences, is focussed on. The capacity for empathetic care has to be emphasized as an integral part of such approach. Finally, in this thesis, the concept of medical futility is tested and applied to clinical case scenarios. It is argued that the traditional medical paradigm, with its justification of an 'all out war' against disease and death, in order to achieve utopia for all, is outdated. Death in the neonatal intensive care unit is increasingly attributed to end-of-life decisions. Futile treatment could be considered a waste of scarce resources, contradicting the principle of nonmaleficence and justice, particularly in an African context. The ongoing confidence in, and uncritical submission to the technological progress in medicine is understood as a defence and coping mechanism against the backdrop of the experience of life's fragility, suffering and the inevitability of death. Such uncritical acceptance of the technological imperative could lead to a harmful fallacy that cure is effected by prolonging life at all cost. What actually occurs, instead, is the prolongation of the dying process, increasing suffering for all parties involved. The historical development of the concept of medical futility is discussed, highlighting its applicability to the paradigmatic scenario of cardio-pulmonary resuscitation. Particular attention is given to ways in which the concept could endanger patient-autonomy by allowing physicians to make unilateral, paternalistic decisions. It is argued that the informative model of the patient-physician relationship, where the physician's role is to disclose information in order for the patient to indicate her preferences, ought to be replaced by a more adequate deliberative model, where both
AFRIKAANSE OPSOMMING: Hierdie tesis bespreek die waarde van mediese futiliteit as 'n maatstaf vir aksie in gevalle van neonatale 'einde-van-lewe' besluite. Die konsep word gekontekstualiseer binne die wêreldbeskouing van mediese vooruitgang, die onsekerheid van mediese prognostikering en die probleme wat geassosieer IS met regverdige hulpbrontoekenning; spesifiek binne die unieke Afrika-situasie. Dit word aangevoer dat die tradisionele mediese paradigma, met regverdiging vir voorkoming van siekte en dood ten alle koste, verouderd is. Sterftes in neonatale intensiewe sorgeenhede word toenemend toegeskryf aan 'einde-van-lewe' besluite Futiele behandeling sou dus beskou kon word as 'n vermorsing van skaars hulpbronne, wat teenstrydig sou wees met die beginsels nie-skadelikheid ('nonmaleficence') en regverdigheid. Die volgehoue vertroue in en onkritiese aanvaarding van aansprake op tegnologiese vooruitgang lil geneeskunde, kan beskou word as verdediging- en hanteringsmeganisme in die belewenis van lewenskwesbaarheid, lyding en die onafwendbaarheid van die dood. Sodanige onkritiese aanvaarding van die tegnologiese imperatief kan tot 'n onverantwoordbare denkfout, naamlik dat genesing plaasvind deur verlenging van lewe ten alle koste, lei. Wat hierteenoor eerder mag plaasvind, is 'n verlenging die sterwensproses en, gepaard daarmee, toenemende lyding van all betrokke partye. Die historiese ontwikkeling van die konsep van mediese futiliteit word bespreek met klem op die toepaslikheid daarvan op die paradigmatiese situasie van kardiopulmonêre resussitasie. Spesifieke aandag word gegee aan maniere waarop die konsep pasiënte se outonomie in gevaar stel, deur die betrokke medici die reg te gee tot eensydige, paternalistiese besluitneming. Die argument is dan dat die informatiewe model, waar die verhouding tussen die dokter en pasiënt gebasseer is op die beginsel dat die dokter inligting moet verskaf aan die pasiënt sodat die pasiënt 'n ingeligte besluit kan neem, vervang moet word met 'n meer toepaslike beraadslagende model, waar sowel die dokter as die pasiënt aktief deelneem aan interaktiewe beraadslaging oor 'n aksieplan. Albei partye word dan moreel verantwoordbaar. So 'n model van beraadslaging het die bykomende voordeel dat dit die beperkings van die deelnemers kan transendeer. Sodoende word 'n hoër-vlak oplossing - iets meer as 'n blote consensus - te weeg gebring. Die argument word ontwikkel dat mediese vooruitgang meelewing met die sterwendes en hul geliefdes mag verberg. Verder dui die literatuur daarop dat die kwaliteit van einde-van-lewe-sorg vir sowel die pasiënte as hul familie onaanvaarbaar is. Dit is binne hierdie konteks dat die konsep van mediese futiliteit kan dien as 'n maatstaf vir aksie. Medici kan nie verantwoordelikheid vir deelname aan beraadslaging rondom eindevan- lewe beluitneming vermy nie, en as sodanig vereis die situasie toenemende bewustheid van sowel die etiese dilemmas as 'n mediese opleidingsmodel waann kommunikasie, konflikhantering, omvattende geskiedenis-neming, met insluiting van die pasient se waardes en voorkeure, beklemtoon word. Die kapasiteit vir empatiese sorg moet weer eens beklemtoon word as 'n integrale deel van hierdie benadering. Ten slotte, hierdie tesis poog om die konsep van mediese futiliteit te toets en toe te pas op kliniese situasies.
Debesai, Yohannes. "Strategies Healthcare Managers Use to Reduce Hospital-Acquired Infections." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6414.
Full textCarroll, Mark J. "Physical Therapists' Perception of Risk of Violating Laws and Rules Governing the Practice of Physical Therapy and/or Their Personal Moral and Ethical Values When Failing to Provide Treatment for an Uninsured or Underinsured Patient." Bowling Green, Ohio : Bowling Green State University, 2007. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=bgsu1193091796.
Full textThomas, Duane J. "Racist white stereotypes and physician race : factors influencing black health care related responses /." Electronic version (PDF), 2005. http://dl.uncw.edu/etd/2005/thomasd/duanethomas.pdf.
Full textPatel, Raakhee Navin. "An Ethnographic Study of Doctor-Patient Communication within Biomedicine and Its Indian Variant in Mumbai." Case Western Reserve University School of Graduate Studies / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=case1619705858186443.
Full textReeher, Jennifer M. "“The Despair of the Physician”: Centering Patient Narrative through the Writings of Charlotte Perkins Gilman." Ohio University / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1523435451243392.
Full textTocionytė, Nelė. "Gydytojo ir paciento santykių etiniai aspektai." Master's thesis, Lithuanian Academic Libraries Network (LABT), 2008. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2007~D_20080520_083030-31723.
Full textThe relationship between a physician and a patient has always been a centre of medical attention. Application of modern technologies enables a physician to receive a clear picture of a patient’s health rather than become concerned about his/her personal feelings. The solution of physician–patient ethical problems is not possible without state economical, political and legal measures. Aim of the study. To assess the ethical aspects of physician-patient relationship of Prienai Primary Health Care Centre from the patients’ attitude. Methods. In January – February 2007, a survey was conducted in order to receive the opinion from Prienai district residents, who visited a GP (n=304). Statistical analysis package SPSS (9.0) was used to analyse the data. Dependence of two symptoms was researched with of the Chi-Square test (χ²). Zero hypothesis was rejected, when p<0,05. Results. A greater part of elderly and young people who have a higher or primary education and high income were satisfied with physician–patient relationship and gave favourable assessment of the administration of the relationship. Middle-aged people who have secondary education and low income were most dissatisfied with the above mentioned. Most favourable opinion about the legal matters was provided by the oldest and youngest group of the city respondents who have high income, whereas middle-aged senior country people who have low income were dissatisfied with the legal matters. Conclusions. The patients were... [to full text]
Hanson, Bernard. "Le malaise du médecin dans la relation médecin-malade postmoderne." Doctoral thesis, Universite Libre de Bruxelles, 2005. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/210989.
Full textLe pouvoir du médecin est évoqué, et se ramène in fine à la fourniture d’un diagnostic et d’une explication de sa maladie au patient. Le rôle des explications particulières que donne le médecin au malade est exploré à la lumière d’une conception narrative et évolutive de la vie humaine. Le rôle du médecin apparaît alors comme d’aider le patient à réécrire a posteriori le fil d’une histoire qui apparaît initialement comme interrompue par la maladie.
Le rôle social de maintien de l’ordre de la pratique médicale est alors évoqué. Ensuite, par une approche descriptive du phénomène religieux, on montre que la médecine du XXIe siècle a les caractéristiques d’un tel phénomène. Entités extrahumaines, mythes, rites, tabous, prétention à bâtir une morale, accompagnement de la vie et de la mort, miracles, promesse de salut, temples, officiants sont identifiés dans la médecine « classique » contemporaine. Seule la fonction de divination de l’avenir d’un homme précis est devenue brumeuse, la technoscience permettant régulièrement du « tout ou rien » là où auparavant un pronostic précis (et souvent défavorable) pouvait être affirmé.
L’hypothèse que la médecine est devenue une religion du XXIe siècle est confrontée à des textes de S. Freud, M. Gauchet et P. Boyer. Non seulement ces textes n’invalident pas l’hypothèse, mais la renforcent même. Il apparaît que le fonctionnement de l’esprit humain favorise l’éclosion de religions et donc la prise de voile de la médecine. La dynamique générale de la démocratisation de la société montre que la médecine est une forme de religion non seulement compatible avec une société démocratique, mais est peut-être une des formes accomplies de celle-ci, où chaque individu écrit lui-même sa propre histoire.
Le danger qu’il y a, pour le patient comme pour le médecin, si ce dernier accepte de jouer un rôle de prêtre, est ensuite développé. Enfin, la remise dans le cadre plus général de l’existence humaine, l’évocation de la dimension de révolte de la médecine, de son essentielle incomplétude, l’acceptation d’une cohérence imparfaite permettent au médecin de retrouver des sources de joie afin de, peut-être, ne tomber ni dans un désinvestissement blasé, ni dans un cynisme blessant.
From a description of the many changes medical practice has undergone for a few decades, the work goes on to study many sides of the modern doctor’s malaise. The gain of power made possible by technoscience is put on a larger stage where information technologies play a major role. The abundance of knowledge makes health literacy more difficult. the great number of observations makes discrepancies with general theories more frequent. The gain in power is associated with a loss of coherence of the medical speech. The doctor’s role vanishes behind technology that seems to be the only access to all medical progresses. Doctors becomes mere service providers and go on to offer unvalidated or even harmful services on the market.
Modern medical power resumes into the explanations and diagnosis given to the patient. The role of medical explanations is explored through an evolutive and narrative vision of human life. The duty of the doctors then appears to allow a new narration of the self that bridges the gap disease introduced into the patient’s life.
The role of medicine in maintaining social order is mentioned. Through a sociological approach of the religious phenomenon, one can see that XXIst century medicine is such a phenomenon. Medicine knows of extrahuman entities, myths, rites, taboos, miracles, temples; priests are present in modern mainstream medicine. Some want to derive objective moral values from medicine, and it brings companionship to man from birth to death. The only departure from old religions was the weakened ability to predict the future of an individual patient: for some diseases for which survival was known to be very poor, the possibilities are now long-term survival with cure, or early death from the treatment.
The hypothesis that medicine is a religion is confronted to texts from Freud S. Gauchet M. and Boyer P. Not only do they not invalidate the hypothesis, but they bring enrichment to it. Brain/mind dynamics is such that the appearance of religions is frequent, and makes the transformation of medicine into a religion easier. Society’s democratisation confronted to religion’s history shows that medicine is the most compatible form of religion within a truly democratic society, where each individual writes his own story.
To become a priest brings some dangers for the patient, but also for the doctor. These dangers are discussed. This discussion is put into the larger context of human life. The revolt dimension of medicine is discussed, as is its never-ending task. Their acceptance, as that of a lack of total logical coherence can open the possibility for the doctor to enjoy his work, without being neither unfeeling nor cynical.
Doctorat en philosophie et lettres, Orientation bioéthique
info:eu-repo/semantics/nonPublished