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    Please use this identifier to cite or link to this item: http://ir.lib.ncu.edu.tw/handle/987654321/77147

    Title: 從信任之向度論述醫病關係;Discussing the Physician-Patient Relationship from the perspective of trust
    Authors: 張綺娟;Chang, Chi-Chuan
    Contributors: 哲學研究所
    Keywords: 醫病關係;信任;有原則的自律;倫理關係自律;親密關係;Physician-Patient Relationship;principled autonomy;ethical relations autonomy;Intimate relation
    Date: 2018-05-21
    Issue Date: 2018-08-31 14:14:29 (UTC+8)
    Publisher: 國立中央大學
    Abstract: 摘要
    近年來醫療糾紛案例層出不窮,醫病緊張的新聞時有所聞,在快速的社會變遷過程中卻造成醫病之間信任度降低。本文以「信任」角度分析尊重自律原則與強調強調病人自主權利的概念下醫病之互動。並探討原則主義(貝參Beau-champ與查爾德斯James F.Childress)、與歐尼爾(Onora O’Neill)依康德之原義重建「有原則的自律」與消除醫病之間的不信任問題。同時,歐尼爾認為從義務詮釋自律原則不但更切合康德的原意,而且,義務或責任與權利不相違抗,毋寧更能展現自律原則的人際結合的意義。我們可以由此建立自律原則更可以促進人際關係,特別是醫病的信任關係;然而,歐尼爾沒有考慮到醫病之間親密程度及信賴程度仍存在著風險與缺乏同情共感的倫理關懷,因此,本文以儒家倫理思想中的「仁」詮釋醫病關係,並以唐朝孫思邈「大醫精誠」之「視病猶親」觀點,探討醫德與專業醫病之信任關係。最後,以儒家「倫理關係自律」為論點,即孝悌是實踐仁道的根本功夫所在並回應上述歐尼爾缺少的內在感通。最後本文探討信任與良好的醫病關係如何使「病人自主權利法」得到最佳的實踐及此法案之優點,讓醫生能以同理心與同情共感之心舒緩病人及家屬的疑慮,呈現感通及仁心情感上的關愛,也能闡述儒家核心的「仁」的精神,使醫病互動更和諧,重建醫病信任關係。

    In recent years, cases of medical disputes have emerged in an endless stream. News of intense medical disputes between patients and physicians have been heard from time to time. In the process of rapid social changes, trust between doctors and patients has been declining. This dissertation analyzes the principle of autonomy under the concept of "trust" and emphasizing patient′s autonomy in patient-physician interaction. This paper also discusses the trust relationship of principlism (Tom Beauchamp and James F. Childress) and Onora O′Neill′s “principled autonomy” as a reconstruction of the principle according to Kant’s original meaning. Trust issues. At the same time, O′Neill believes that the interpretation of the principle of autonomy as obligation not only is more in line with Kant′s original intentions, but also that obligations or responsibilities do not defy rights, and rather it demonstrates better the importance of interpersonal integration of the principle of self-discipline. We can thus establish a principle of self-discipline that can promote interpersonal relationships, especially the relationship of trust between doctors and patients. However, O′Neill neglects the importance of the relation of intimacy and trust between doctors and patients and still risks and the lack of ethical concerns because of lack of sympathy. Therefore, I interpret the relationship between doctors and patients with the concept of ren (benevolence) in Confucian ethics and expand the use of the viewpoint of treating patients as family members in the view of the Tang Dynasty doctor Sun Sie-yi. I introduce the Confucian concept of “ethical relational autonomy” as it is developed by Professor Shui Chuen Lee in response to the lack of mutual concerns mentioned above. Finally, I try to assess the contribution of trust by the “Patient Autonomy Rights Ac.t”. Doctors should empathize with the feelings of empathy and sympathy to ease the doubts of patients and their families. The emotional and caring nature of the heart can also explain the Confucian spirit of “benevolence”, make the interaction between doctors and patients more harmonious, and rebuild the trust physician-patient relationship。
    Appears in Collections:[哲學研究所] 博碩士論文

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