Naujausi A B C D E F G H I J K L M N O P R S T V W Y Z

ISBN: 0-13-290545-0
Brūkšninis kodas: 4036694
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     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.

Foreword; Progress in ethics vii
Eric J. Cassell
Preface x
Medicine`s challenge to ethics 1
The initial idea 1 The philosopher`s response 4 Applied ethics 6 The Backlash
Against ethics 9 The Backlash continues 11 “Clinical” versus “Biomedical”
ethics 13 A clinical example 14 Critique of the case 14 Heterogeneity of moral
views 16 Medicine`s dilemma 18 The challenge: A first look 19 Toward another
approach: A case study 21 Developing a response ethics 27
The moral dimension of medicine: Preliminary reflections 29
The complex field of medical work 30 An illustrative case 32 The social context of
Patients 34 Several clues to being morally responsive 36 The moral resolve and its
Specifications 38 Sources of moral conflict 41 Review: Case and comment 44
The moral basis of medicine: Another view 50
“How the hell did I get here?”:
The patient`s place in the therapeutic dyad 53
A phenomenology of illness: Outline 53 Patients present themselves 56 “What`s
Wrong with me?” “Do you really care?” 62 Tears in the fabric of daily life 65
Unavoidable trust 69 The experience of being cared for 71 Soundings at uncertain
Levels 75 Who is my stranger? 80 Power and vulnerability 84 The helping
Relation as promise 86 “Telling” illness: Gratitude and luck 88
Patient discource and medicine`s history 92
The complexity of the field 92 Medicine`s two sides: A historical irony 94 The text
Of the clinical context 96 The stages of clinical judgment 99 Deficiency of the
received view 102 The displacement of the patient 104 Cartesian dualism 106
The Cartesian puzzle 108 Descartes as medical consultant 110 Descartes`s
anatomy and physiology 112 Dualism revisited 114 The body-machine
analogy 117 The living body, the dead cadaver: The “Subtle hoax” 120
The oddity of ordinary life 123 The post-Cartesian context 126 The elusive
Everyday: A historical theme 127
Themes from medicine`s history: Interpretive reconsiderations 130
Human anatomy: A first look 132 Between Descartes and Bichat 135 Conflict of
Interpretation in ancient medicine 137 The first clue: Interpretation of symptoms
140 The dogmatic doctrine 142 The empiric tradition 146 The Descartes-Bichat
difference revisited 150
The anatomist`s conceit, the body`s cunning 154
Reductivism and dualism in current medicine 155 The anomaly of Gallows humor
157 The soma and the corpse 159 The historical thematic 162 The postmortem in
medieval medicine 164 Mind and body as historical artifacts 165 The corpse and
the soal 168 The empiric-dogmatic dispute revisited 170 The therapeutic dyad
reconsidered 172 A review of the terrain 174
Skepticism in medicine 177
Hellenistic and Hippocratic empiricism 177 Medical Methodism 180 The skeptic`s
circumstantial understanding 182 The historical irony of the human corpse 184
The place of Galen 188 Anatomy in the ancient world 190 The retreat of life(soul)
197 The improvement of man 199
Ethics in ancient medicine 202
Medical morality and medical power 202 The Hippocratic oath and medical
Morality 205 Hippocratic morality 210 The ethics of Methodism 219 Summing
Up 221
Clinical-liaison ethics: Part I 224
“Why won`t you let me die?” 225 Everyone did what they could, right? 234 What
went wrong? 236 Ethics as clinical liaison 242 Enablement 248
Clinical-liaison ethics: Part II 251
The work of helping strangers 251 Dilemmas of necessary distancing 255 The
Aftermath of distancing: Good times and bad 259 Addressing aftermaths 263
Clinical conversation: A clue 266 Description in clinical-liaison ethics 267
A rule of method 269 Interpretation in clinical-liaison ethics 270 A second
Rule of method 272 Understanding moral themes 273 Topical, interpretive,
And motivational schemata 275 The documentary method 279
Trust and care: Toward a moral foundation 283
Review of the terrain 283 The idea of the autonomous moral agent 285
Assumptions underlying autonomy 288 A case in point: The dialysis
patient 293 Falling ill 295 The idea of “Moral chance” 297 “Accident
of birth” and moral imbalance 300 Awakening a moral sense: “Good
fortune obligates” 303 Awakening a moral sense: Gratitude and response 305
The twofold meaning of awakening a moral sense 307 The ESRD-Dialysis
patient`s “Good fortune” 308 Illness and the moral order 310 Intent in
patient-physician discourse 312 Affiliative feeling: “Put yourself in my shoes” 315
A finalword 319

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