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dc.contributor.authorQualtere-Burcher, Paul, 1963-
dc.date.accessioned2012-04-16T22:44:27Z
dc.date.available2012-04-16T22:44:27Z
dc.date.issued2011-12
dc.identifier.urihttp://hdl.handle.net/1794/12146
dc.descriptionxii, 163 p.en_US
dc.description.abstractThe 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.sponsorshipCommittee in charge: Naomi Zack, Chairperson; Cheyney Ryan, Member; Mark Johnson, Member; Mary Wood, Outside Memberen_US
dc.language.isoen_USen_US
dc.publisherUniversity of Oregonen_US
dc.relation.ispartofseriesUniversity of Oregon theses, Dept. of Philosophy, Ph. D., 2011;
dc.rightsrights_reserveden_US
dc.subjectPhilosophy of scienceen_US
dc.subjectMedical ethicsen_US
dc.subjectPhilosophy, religion and theologyen_US
dc.subjectHealth and environmental sciencesen_US
dc.subjectPhysician paternalismen_US
dc.subjectDoctor-patient relationshipsen_US
dc.subjectBioethicsen_US
dc.subjectPhilosophy of medicineen_US
dc.subjectPhysician and patient
dc.titleRe-thinking the Doctor-Patient Relationship: A Physician’s Philosophical Perspectiveen_US
dc.typeThesisen_US


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