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- Gelhaus, Petra
(författare)
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I, Medical Robot. On the differences between virtuous doctor and a good robot
- 2011
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Ingår i: The International Journal of Person Centered Medicine. - : University of Buckingham Press. - 2043-7730 .- 2043-7749. ; 1:2, s. 301-306
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Tidskriftsartikel (refereegranskat)abstract
- Rationale, aims and objectives: The aim of this article is to argue for the necessity of emotional professional virtues in the understanding of good clinical practice. This understanding is required for a proper balance of capacities in medical education and further education of physicians. For this reason, an ideal physician, incarnating the required virtues, skills and knowledge, is compared with a non-emotional robot that is bound to moral rules. This fictive confrontation is meant to clarify why certain demands on the personality of the physician are justified, in addition to a rule- and principle-based moral orientation and biomedical knowledge and skills.Methods: Philosophical analysis of thought experiments inspired by science fiction literature by Isaac Asimov.Results: Though prima facie a rule-oriented robot seems more reliable and trustworthy, the complexity of clinical judgment is not met by an encompassing and never contradictory set of rules from which one could logically derive decisions. There are different ways in which the robot could still work, but at the cost of the predictability of its behaviour and its moral orientation. In comparison, a virtuous human doctor who is also bound to these rules, though less strictly, will more reliably keep to moral objectives, be understandable, be more flexible in case the rules come to their limits and will be more predictable in these critical situations. Apart from these advantages of the virtuous human doctor referring to his own person, the most problematic deficit of the robot is its lacking deeper understanding of the inner mental events of patients which makes good contact, good communication and good influence impossible.Conclusion: Though an infallibly rule-oriented robot seems more reliable at first view, in situations that require complex decisions such as clinical practice, the agency of a moral human person is more trustworthy. Since this is a crucial precondition for good clinical practice, sufficient attention should be given to develop these virtues in addition to the usual attention on knowledge, skills and adherence to moral rules and principles.
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- Rydell Karlsson, Monica, et al.
(författare)
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Patients with chronic heart failure who plan their own self- care education decrease their outpatient visits
- 2011
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Ingår i: The International Journal of Person Centered Medicine. - 2043-7730 .- 2043-7749. ; 1:4, s. 705-718
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Tidskriftsartikel (refereegranskat)abstract
- Background, aims and objectives: Patient education programs delivering a defined package of information aimed to optimise the care of chronic heart failure have been evaluated. However, there is a lack of knowledge about the effects of programs designed to support the patients’ learning by allowing them to self-direct their learning activities. We aimed to contribute to the associated knowledge base.Method: We compared an intervention group of patients choosing among different learning activities with a control group, where the nurse practitioner scheduled a package of learning activities. One hundred and eighty two patients with chronic heart failure in NYHA class I-IV who were referred to the nurse practitioner outpatient clinic randomised to either a structured control education program (92 patients) or to a self-directed intervention program (90 patients). Additionally, both groups received the same nurse-practitioner based self-care advice and treatment. Outcome measures were quality of life, knowledge acquisition, visits to the outpatient clinic, readmissions and medication during one year.Results: All patients significantly increased their knowledge and quality of life, with no difference between the groups. However, the intervention group patients had fewer visits to the outpatient clinic as compared to controls (p=0.007). This was accomplished without a concomitant increase in re-admission rate. Both groups increased, as intended, their use of angiotensin converting enzyme inhibitors, angiotensin receptor blockers and beta-blockers.Conclusion: In conclusion, our findings show that it is safe and results in fewer outpatient visits if patients with chronic heart failure actively plan their own education program. To encouraging patients taking own decisions lead to an increased self-control of their healthcare behaviour.
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- Jangland, Eva, et al.
(författare)
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Patients' complaints about negative interactions with health professionals in a surgical setting
- 2011
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Ingår i: International Journal of Person Centered Medicine. - Buckingham : The University of Buckingham Press. - 2043-7749. ; 1:4, s. 756-765
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe the experiences of patients who complain about negative interactions with health professionals in a surgical setting. The study was based on interviews with patients (n = 15) who had contacted their local Patients’ Advisory Committee to report their negative interaction with health professionals in a large university hospital in Sweden. Exploring the experiences of patients who report negative interactions may be a starting point for learning about the patients’ views of the health care organisation, and this information may contribute to quality improvement. The interviews were analysed using qualitative content analysis. Patients’ experiences of negative interactions are described under three main themes: ‘having lost confidence’, ‘feeling like a nuisance’ and ‘feeling abandoned and lonely’. Negative interactions with health professionals caused long-term consequences for patients, including suffering, insecurity, and worry. It also reduced their confidence in upcoming consultations. From the patients’ perspective a caring relationship with health professionals and reliable, appropriate, and timely information are vital to high quality care. Patient access to information and positive interactions with health professionals should be routine quality indicators in the surgical care unit. In the process of quality improvement, all health professionals need to be involved in setting goals, making small tests of changes, and evaluating outcomes. Patients’ stories of negative interactions could provide the impetus for professional reflection sessions in the surgical care unit and for education for all health professionals to develop new competence in patient relations
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