Ethics And The Clinical Encounter

Ethics And The Clinical Encounter

by Richard M Zaner
     
 

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ISBN-10: 0788099396

ISBN-13: 9780788099397

Pub. Date: 02/01/2004

Publisher: CSS Publishing

Ethics and the Clinical Encounter explores the moral dimensions of clinical medicine and the phenomenon of illness, to determine what ethics must be in order to be fully responsive to clinical encounters. Written in a lively and conversational style with minimal technical terminology, and enhanced by actual experience or real clinical situations, this volume lays out

Overview

Ethics and the Clinical Encounter explores the moral dimensions of clinical medicine and the phenomenon of illness, to determine what ethics must be in order to be fully responsive to clinical encounters. Written in a lively and conversational style with minimal technical terminology, and enhanced by actual experience or real clinical situations, this volume lays out a clinical ethics methodology both in practical and theoretical terms.

Product Details

ISBN-13:
9780788099397
Publisher:
CSS Publishing
Publication date:
02/01/2004
Pages:
356
Sales rank:
925,750
Product dimensions:
6.00(w) x 9.00(h) x 0.74(d)

Table of Contents

Foreword: Progress in Ethicsvii
Prefacex
Chapter 1Medicine's Challenge to Ethics1
The Initial Idea1
The Philosopher's Response4
Applied Ethics6
The Backlash Against Ethics9
The Backlash Continues11
"Clinical" Versus "Biomedical" Ethics13
A Clinical Example14
Critique of the Case14
Heterogeneity of Moral Views16
Medicine's Dilemma18
The Challenge: A First Look19
Toward Another Approach: A Case Study21
Developing a Responsive Ethics27
Chapter 2The Moral Dimension of Medicine: Preliminary Reflections29
The Complex Field of Medical Work30
An Illustrative Case32
The Social Context of Patients34
Several Clues to Being Morally Responsive36
The Moral Resolve and Its Specifications38
Sources of Moral Conflict41
Review: Case and Comment44
The Moral Basis of Medicine: Another View50
Chapter 3"How the Hell Did I Get Here?": The Patient's Place in the Therapeutic Dyad53
A Phenomenology of Illness: Outline53
Patients Present Themselves56
"What's Wrong with Me?" "Do You Really Care?"62
Tears in the Fabric of Daily Life65
Unavoidable Trust69
The Experience of Being Cared For71
Soundings at Uncertain Levels75
Who Is My Stranger?80
Power and Vulnerability84
The Helping Relation as Promise86
"Telling" Illness: Gratitude and Luck88
Chapter 4Patient Discourse and Medicine's History92
The Complexity of the Field92
Medicine's Two Sides: A Historical Irony94
The Text of the Clinical Context96
The Stages of Clinical Judgment99
Deficiency of the Received View102
The Displacement of the Patient104
Cartesian Dualism106
The Cartesian Puzzle108
Descartes as Medical Consultant110
Descartes's Anatomy and Physiology112
Dualism Revisited114
The Body-Machine Analogy117
The Living Body, the Dead Cadaver: The "Subtle Hoax"120
The Oddity of Ordinary Life123
The Post-Cartesian Context126
The Elusive Everyday: A Historical Theme127
Chapter 5Themes from Medicine's History: Interpretive Reconsiderations130
Human Anatomy: A First Look132
Between Descartes and Bichat135
Conflict of Interpretation in Ancient Medicine137
The First Clue: Interpretation of Symptoms140
The Dogmatic Doctrine142
The Empiric Tradition146
The Descartes-Bichat Difference Revisited150
Chapter 6The Anatomist's Conceit, the Body's Cunning154
Reductivism and Dualism in Current Medicine155
The Anomaly of Gallows Humor157
The Soma and the Corpse159
The Historical Thematic162
The Postmortem in Medieval Medicine164
Mind and Body as Historical Artifacts165
The Corpse and the Soul168
The Empiric-Dogmatic Dispute Revisited170
The Therapeutic Dyad Reconsidered172
A Review of the Terrain174
Chapter 7Skepticism in Medicine177
Hellenistic and Hippocratic Empiricism177
Medical Methodism180
The Skeptic's Circumstantial Understanding182
The Historical Irony of the Human Corpse184
The Place of Galen188
Anatomy in the Ancient World190
The Retreat of Life (Soul)197
The Improvement of Man199
Chapter 8Ethics in Ancient Medicine202
Medical Morality and Medical Power202
The Hippocratic Oath and Medical Morality205
Hippocratic Morality210
The Ethics of Methodism219
Summing Up221
Chapter 9Clinical-Liaison Ethics: Part I224
"Why Won't You Let Me Die?"225
Everyone Did What They Could, Right?234
What Went Wrong?236
Ethics as Clinical Liaison242
Enablement248
Chapter 10Clinical-Liaison Ethics: Part II251
The Work of Helping Strangers251
Dilemmas of Necessary Distancing255
The Aftermath of Distancing: Good Times and Bad259
Addressing Aftermaths263
Clinical Conversation: A Clue266
Description in Clinical-Liaison Ethics267
A Rule of Method269
Interpretation in Clinical-Liaison Ethics270
A Second Rule of Method272
Understanding Moral Themes273
Topical, Interpretive, and Motivational Schemata275
The Documentary Method279
Chapter 11Trust and Care: Toward a Moral Foundation283
Review of the Terrain283
The Idea of the Autonomous Moral Agent285
Assumptions Underlying Autonomy288
A Case in Point: The Dialysis Patient293
Falling Ill295
The Idea of "Moral Chance"297
"Accident of Birth" and Moral Imbalance300
Awakening a Moral Sense: "Good Fortune Obligates"303
Awakening a Moral Sense: Gratitude and Response305
The Twofold Meaning of Awakening a Moral Sense307
The ESRD-Dialysis Patient's "Good Fortune"308
Illness and the Moral Order310
Intent in Patient-Physician Discourse312
Affiliative Feeling: "Put Youself in My Shoes"315
A Final Word319
Bibliography321
Index329

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