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Models of the Doctor-Patient Relationship and the Ethics Committee: Part Two

Published online by Cambridge University Press:  29 July 2009

David C. Thomasma
David C. Thomasma
Affiliation:
Fr. Michael I. English, S.J., Professor of Medical Ethics and Director of the Medical Humanities Program at Loyola University Chicago Medical Center and the Director of the International Bioethics Institute
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Extract

Past ages of medical care are condemned in modern philosophical and medical literature as being too paternalistic. The normal account of good medicine in the past was, indeed, paternalistic in an offensive way to modern persons. Imagine a Jean Paul Sartre going to the doctor and being treated without his consent or even his knowledge of what will transpire during treatment! From Hippocratic times until shortly after World War II, medicine operated in a closed, clubby manner. The knowledge learned in medicine was not shared with the patients, who were in general poorly educated and for the most part completely ignorant of the craft of medicine and the physicians (but not, perhaps, of folk medicine). Physicians were cautioned against telling patients too much about their Illness and/or their recovery, perhaps because physicians themselves did not have an enormous armamentarium to confront disease.

Type
Special Section: Healthcare Relationships: Ties that Bind
Information
Cambridge Quarterly of Healthcare Ethics , Volume 3 , Issue 1 , Winter 1994 , pp. 10 - 26
Copyright
Copyright © Cambridge University Press 1994

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References

Notes

1. Jonsen, A. What does life support support? In: Winslade, W, ed. Personal Choices and Public Commitments: Perspectives on the Humanities. Galveston, Texas: Institute for the Medical Humanities, 1988:61–9.Google Scholar

2. Thomasma, DC. Models of the doctor-patient relationship and the ethics committee: part one. Cambridge Quarterly of Healthcare Ethics 1992;1:11–31.CrossRefGoogle ScholarPubMed

3. Pellegrino, ED, Thomasma, DC. For the Patient's Good: The Restoration of Beneficence in Health Care. New York: Oxford University Press, 1988.Google Scholar

4. Pellegrino, ED. Rationing health care: the ethics of medical gatekeeping. The Journal of Contemporary Health Law and Policy 1986;2:23–45.Google Scholar

5. May, WF. The Physician's Covenant, Philadelphia: Westminster Press, 1983.Google Scholar

6. Thomasma, DC. The ethics of caring for vulnerable individuals. In: Reflection on Ethics. Washington, D.C.: American Speech-Language-Hearing Association, 1990:39–45.Google ScholarPubMed

7. Anonymous. Reform will come slowly, look like managed competition. Pulse: The Health Care Reform Newsletter 1993; 1(1): 16.Google Scholar

8. Gesensway, D. Managed competition: a better system or a wedge between doctors and patients? ACP Observer 1993;13(1):1, 15.Google Scholar

9. ACP Viewpoint. ACP carefully reviewing managed competition. ACP Observer 1993;13(1):15.Google Scholar

10. Buxbaum, R. German physicians' prescribing practices lead to calls for reform. ACP Observer 1993;13(1):5.Google Scholar

11. Veatch, RM. The Patient-Physician Relationship: The Patient as Partner, Part 2. Bloomington: Indiana University Press, 1991:63.Google Scholar

12. See note 11. Veatch, . 1991.Google Scholar

13. See note 11. Veatch, . 1991:67.Google Scholar

14. Veatch, RM. A Theory of Medical Ethics. New York: Basic Books, 1981:324–30.Google ScholarPubMed

15. See note 11. Veatch, . 1991:67.Google Scholar

16. See note 11. Veatch, . 1991:68.Google Scholar

17. See note 11. Veatch, . 1991:75–6.Google Scholar

18. Ramsey, P. The Patient as Person. New Haven, Connecticut: Yale University Press, 1970.Google Scholar

19. Kass, L. “I will give no deadly drug.” Why doctors must not kill. American College of Surgeons Bulletin 1992;77:6–17.Google Scholar

20. Engelhardt, HT Jr. Bioethics and Secular Humanism. Philadelphia/London: Trinity Press haternational/SOM Press, 1991.Google Scholar

21. Engelhardt, HT Jr. The Foundations of Bioethics. New York: Oxford University Press, 1986.Google ScholarPubMed

22. Brock, DW. The ideal of shared decision making between physicians and patients. Kennelly Institute of Ethics Journal 1991;1(1):28–47.CrossRefGoogle Scholar

23. Veatch, RM. Models for ethical medicine in a revolutionary age. Hastings Center Report 1972;2:5–7.CrossRefGoogle Scholar

24. Rodning, CB. Coping with ambiguity and uncertainty in patient-physician relationships. I. Leadership of a physician. II. Traditio argumentum respectus. III. Negotiation. Journal of Medicine and the Humanities 1992;13:91–101, 147–56, 211–22. Quote from 212.CrossRefGoogle Scholar

25. Siegler, M. The physician-patient accommodation: a central event in clinical medicine. Archives of Internal Medicine 1982;142:1899–1902.CrossRefGoogle ScholarPubMed

26. Brody, H. The Healer's Power. New Haven, Connecticut: Yale University Press, 1992.Google ScholarPubMed

27. Thomasma, DC. Beyond medical paternalism and patient autonomy. A model of physician conscience for the physician-patient relationship. Annals of Internal Medicine 1983;98:243–8.CrossRefGoogle ScholarPubMed

28. Fried, TR, Stein, MD, O'Sullivan, PS, Brock, DW, Novack, DH. Limits of patient autonomy: physician attitudes and practices regarding life-sustaining treatments and euthanasia. Archives of Internal Medicine 1993;153:722–8.CrossRefGoogle ScholarPubMed

29. Pellegrino, ED, Thomasma, DC. A Philosophical Basis of Medical Practice. New York: Oxford University Press, 1981.Google Scholar

30. Bergsma, J, Thomasma, DC. Health Care: Its Psychosocial Dimensions. Pittsburgh, Pennsylvania: Duquesne University Press, 1982.Google Scholar

31. Cassell, E. The function of medicine. Hastings Center Report 1977;7(7):16–9.CrossRefGoogle Scholar

32. See note 30. Bergsma, , Thomasma, . 1982.Google Scholar

33. Pellegrino, ED, Thomasma, DC. The conflict between autonomy and beneficence in medical ethics: proposal for a resolution. Journal of Contemporary Health Law and Policy 1987;3:23–46.Google ScholarPubMed

34. Cassel, E. Do justice, love mercy. The inappropriateness of the concept of justice applied to bedside decisions. In: Shelp, E, ed. Justice and Health Care. Boston: D. Reidel, 1981:75–82.CrossRefGoogle ScholarPubMed

35. See note 3. Pellegrino, , Thomasma, . 1988.Google Scholar

36. Thomasma, DC. How do we determine treatment for incompetent patients? Medical Ethics 1991;6(2):3–4.Google Scholar

37. Thomasma, DC, Pellegrino, ED. Challenges for a philosophy of medicine of the future: a response to fellow philosophers in The Netherlands. Theoretical Medicine 1987;8:187–204.CrossRefGoogle ScholarPubMed