Autonomy And Clinical Medicine: Renewing The Health Professional Relation With The Patient (international Library Of Ethics, Law, And The New Medicine)

This book arises from a two-fold conviction. The first is that autonomy, despite recent critiques about its importance in bioethics and philosophy of medicine, and the traditional resistance of medicine to its "intrusion" into the doctor-patient relation, is a fundamental building block of an individual's identity and mechanisms for dealing with illness, disease, and incapacity. As such it is an essential component in the health care professional's armamentarium employed to bring about healing. Furthennore, it functions in a similar way to assist the health professional in his or her relations to the sick and injured. The second conviction follows from the fITst. Autonomy is far more complex than appears from the philosophical use of the concept. In this conviction we join those who have criticized the over-reliance on autonomy in modem, secular bioethics originating in the United States, but gaining ascendancy in other cultures. This critique relies on appeals to the richer contexts of persons' lives. Elsewhere the contemporary critique of autonomy appears in a variety of alternative ethical models like narrative ethics, casuist ethics, and contextualism. Indeed, postmodern criticism of all bioethics argues that there is no defensible foundation for claims that one ought to respect autonomy or any other principle as a way of ensuring that one is ethical.

This book is the result of a long-standing clinical and educational cooperation between a medical psychologist (Bergsma) and a medical ethicist/philosopher (Thomasma). It is thoroughly interdisciplinary in its examination of the difficulties of honoring the patient's and the physician's autonomy, especially in light of the changes in health care worldwide today.
Although autonomy has become the primary standard of bioethics, little has been done to link it to the ways people actually behave, nor to its roots in the healing relationship. Combining as it does the disciplines of psychology and philosophy, this book is a step in that direction.

Front Matter....Pages i-xvii Front Matter....Pages 1-1 Autonomy as a Behavioral Concept....Pages 3-22 Autonomy, Identity, and Physical Disruption....Pages 23-43 Autonomy in the Doctor-Patient Encounter....Pages 45-73 Front Matter....Pages 75-75 Modes of Autonomy....Pages 77-88 Freedom and the Social Goals of Medicine....Pages 89-101 Moving Beyond Autonomy to the Person with Illness....Pages 103-119 Autonomy and Ethical Modes of the Doctor-Patient Relationship....Pages 121-141 Front Matter....Pages 143-143 Reconstituting the Doctor-Patient Relation....Pages 145-160 Back Matter....Pages 161-202