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THE NATURE OF THE CLINICAL ENCOUNTER

Explore the intricate balance of clinical decisions and moral choices within the medical field, delving into values, patient vulnerabilities, caregiver strengths, and the essence of the clinical encounter.

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THE NATURE OF THE CLINICAL ENCOUNTER

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  1. THE NATURE OF THE CLINICAL ENCOUNTER AN OVERVIEW

  2. CLINICAL DECISION MAKING • EVERY CLINICAL DECISION INVOLVES A MORAL DECISION • CHOICES OF ENDS AND MEANS • MULTIPLE VIEWS OF “THE GOOD LIFE” IN A PLURALISTIC SOCIETY • VALUES; INDIVIDUAL, COMMUNITY, INSTITUTION • MEDICAL GOODS AS ONE FACET OF DECISIONS • STRATEGIES FOR IMPLEMENTING DECISIONS

  3. PATIENT WEAKNESS [VULNERABILITY] DISEASED STATE IGNORANCE FEAR PATIENT STRENGTH KNOWLEDGE OF, AND COMMITMENT TO, MORAL GOODS FOR SELF CAREGIVER STRENGTH MEDICAL EXPERTISE COMMITMENT TO HEALTH AND HEALING POWER DIAGNOSTIC, PROGNOSTIC, AND THERAPEUTIC KNOWLEDGE, SKILL, AND AUTHORITY FAMILIARITY AND COMFORT CAREGIVER WEAKNESS KNOWLEDGE OF FULL RANGE OF MORAL GOODS FOR PATIENT [KNOWLEDGE OF, AND COMMITMENT TO, MORAL GOODS FOR SELF EITHER AS PROFESSIONAL GOODS OR PERSONAL GOODS] THE CLINICAL ENCOUNTERVALUE ENCOUNTER + MEDICAL COMPLAINTCOLLABORATION IN COMMON ENTERPRISE

  4. THE GOALS OF MEDICINETHE HASTINGS CENTER (1996) • THE PREVENTION OF DISEASE AND INJURY AND PROMOTION AND MAINTENANCE OF HEALTH • THE RELIEF OF PAIN AND SUFFERING CAUSED BY MALADIES • THE CARE AND CURE OF THOSE WITH A MALADY, AND THE CARE OF THOSE WHO CANNOT BE CURED • THE AVOIDANCE OF PREMATURE DEATH AND THE PURSUIT OF A PEACEFUL DEATH

  5. ASPIRATIONS OF MEDICINETHE HASTINGS CENTER (1996) • TO BE HONORABLE AND TO DIRECT ITS OWN PROFESSIONAL LIFE • TO BE TEMPERATE AND PRUDENT • TO BE AFFORDABLE AND ECONOMICALLY SUSTAINABLE • TO BE JUST AND EQUITABLE • TO BE RESPECTFUL OF HUMAN CHOICE AND DIGNITY

  6. THE GOALS OF MEDICINEAMERICAN COLLEGE OF PHYSICIANS (1984) • PROMOTE HEALTH • RELIEVE SUFFERING • PREVENT UNTIMELY DEATH • MAINTAIN THE DIGNITY OF THE PATIENT • NOTE THE EMPHASIS ON THE PATIENT AS THE FOCUS OF HEALTHCARE

  7. HIPPOCRATESTHE ART OF MEDICINE • FIRST OF ALL I WOULD DEFINE MEDICINE AS THE COMPLETE REMOVAL OF THE DISTRESS OF THE SICK, THE ALLEVIATION OF THE MORE VIOLENT DISEASES, AND THE REFUSAL TO UNDERTAKE TO CURE CASES IN WHICH THE DISEASE HAS ALREADY WON THE MASTERY, KNOWING THAT EVERYTHING IS NOT POSSIBLE TO MEDICINE.

  8. HIPPOCRATESTHE ART OF MEDICINE • A MAN WHO THINKS THAT A SCIENCE CAN PERFORM WHAT IS OUTSIDE ITS PROVINCE, OR THAT NATURE CAN ACCOMPLISH UNNATURAL THINGS, IS GUILTY OF IGNORANCE MORE AKIN TO MADNESS THAN TO LACK OF LEARNING. • WHEN A MAN IS ATTACKED BY A DISEASE MORE POWERFUL THAN THE INSTRUMENTS OF MEDICINE, IT MUST NOT BE EXPECTED THAT MEDICINE SHOULD PROVE VICTORIOUS.

  9. HIPPOCRATESTHE ART OF MEDICINE • I ASSERT THAT, WHEN THE PHYSICIANS FAIL, IT IS THE POWER OF THE DISEASE WHICH IS RESPONSIBLE AND NOT DEFICIENCIES IN THE SCIENCE OF MEDICINE.

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