摘要
医患共同决策是理想的临床决策模式。它强调医患之间是一种合作伙伴关系,医生与患方之间应彼此交流,相互分享信息,双方同为决策主体,共同选择诊疗方案。但在现实环境下,医患面临诸多的决策困境。叙事医学让医生重视叙事的价值,并要求医生通过关注病人叙事来关注全人、见证病人的痛苦,与病人同在,最终与他们建立归属关系。叙事医学的临床实践有助于化解决策困境,对顺利实现医患共同决策有重要的作用,但需要不断在地化发展。
The shared decision making is an ideal clinical decision making model.It emphasizes that the doctor-patient relationship is a kind of partnership.Doctors and patients should communicate with each other,share information with each other,and both sides are the decision making bodies to jointly choose diagnosis and treatment procedures.However,in the real practice,doctors and patients face many difficulties in decision making.Narrative medicine makes doctors pay attention to the value of narrative,and requires doctors to pay attention to the whole person,witness the sufferings of patients,be with patients,and finally establish a relationship of belonging with each other.The clinical practice of narrative medicine is helpful to resolve the dilemma of decision making,and plays an important role in the smooth realization of the shared decision making,but it also needs continuous development of localization.
作者
朱利明
ZHU Li-ming(Department of Medical Oncology, Cancer Hospital, University of Chinese Academy of Sciences/Zhejiang Cancer Hospital, Hangzhou 310022, China)
出处
《医学与哲学》
2020年第2期7-10,共4页
Medicine and Philosophy
关键词
叙事医学
临床决策
医患共同决策
narrative medicine
clinical decision making
shared decision making
