THE PATIENT IS NOT A THING. REMARKS ON POSSIBLE POSITIVE INFLUENCE OF BIOETHICS ON PHYSICIANS' ATTITUDES (Pacjent nie jest rzecza. Uwagi o mozliwym korzystnym wplywie bioetyki na postawy lekarzy)
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The article discusses the question of proper relations between physicians and their patients. Medical ethics - the traditional one (Hippocratean) and the contemporary one which bases on bioethics - determines medical goals, appoints physicians' responsibilities, and assumes certain system of values which should be observed by physicians. There are differences between the two. The former is usually code, deontological or, in a way, paternal ethics (even when it talks about the patient's rights and autonomy). The latter on a metaethical level tries to describe the most important goals and means, it gives more room for individual choice, and it demands reflection, consideration and evaluation of situation both from the physician and the patient. That is why bioethics is not valued by physicians because it complicates matters, it does not give unambiguous advice, and it is not particularly well-known (bioethical issues have little share in educating physicians and contacts between bioethicists and physicians are scarce). The author shows that two bioethical standpoints (principialism and personalism), though considered as opposing, share the same goal (the patient's good, concern for the patient, non-instrumental treatment of the patient). Independently of which of the bioethical standpoints is considered correct, the knowledge of bioethical issues and ability to solve bioethical dilemmas enable to shape critical thinking and imagination which is the basis of so important features as modesty, care (or prudence), sensitivity, and responsibility. If persuasive power of ethics can be shown, then it is also possible to attribute such a property to bioethics. Realizing (and feeling) who the patient is, learning about asymmetry in relations between the physician and the patient can positively influence the physician's attitude. Given examples of reprehensible (instrumental only) treating of patients and the reasons behind the examples (strong, unjustified paternalism of physicians, arrogance, routine, incompetence, lack of sensitivity, bad job organization, economic issues set as priority) prove that what is an axiomatically assumed principle in medicine and medical professions has not been internalized by some physicians. The postulate that all physicians should be fluent in bioethical issues is exaggerated. The requirement that the patient is viewed and treated as a person is fundamental.
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