Re-thinking the Doctor-Patient Relationship: A Physician’s Philosophical Perspective

Show simple item record Qualtere-Burcher, Paul, 1963- 2012-04-16T22:44:27Z 2012-04-16T22:44:27Z 2011-12
dc.description xii, 163 p. en_US
dc.description.abstract The 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. en_US
dc.description.sponsorship Committee in charge: Naomi Zack, Chairperson; Cheyney Ryan, Member; Mark Johnson, Member; Mary Wood, Outside Member en_US
dc.language.iso en_US en_US
dc.publisher University of Oregon en_US
dc.relation.ispartofseries University of Oregon theses, Dept. of Philosophy, Ph. D., 2011;
dc.rights rights_reserved en_US
dc.subject Philosophy of science en_US
dc.subject Medical ethics en_US
dc.subject Philosophy, religion and theology en_US
dc.subject Health and environmental sciences en_US
dc.subject Physician paternalism en_US
dc.subject Doctor-patient relationships en_US
dc.subject Bioethics en_US
dc.subject Philosophy of medicine en_US
dc.subject Physician and patient
dc.title Re-thinking the Doctor-Patient Relationship: A Physician’s Philosophical Perspective en_US
dc.type Thesis en_US

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