The doctor-patient relationship from the perspective of Pelle- grino and Thomasma
DOI:
https://doi.org/10.26512/rbb.v10i1-4.7694Keywords:
Edmund D. Pellegrino, doctor-patient relationship, beneficence, bioethics.Abstract
The author analyzes the doctor-patient relationship, considered the cornerstone of medical practice, from the perspective of Edmund D. Pellegrino and David C. Thomasma. We describe the main characteristics of the business and contractual models in clinical relationship situations, highlighting the proposal of Pellegrino and Thomasma of beneficence-in-trust. This model is based on the trust that should exist between doctor and patient, and takes into account four components of the good of the patient: the biomedical good, the patients’s own perception of the good, the good for the patient as a human, and the spiritual or ultimate good. It is an approach that values the autonomy and the dignity of the patient as a person, preserves his vulnerability from the scientific and technological advances in medicine but gives the doctor a key and active role in the search of the patient’s good.
References
Pellegrino ED, Thomasma DC. For the patient’s good: toward the restoration of beneficence in health care. New York: Oxford University Press; 1988: 101-6.
Pellegrino ED. The four principles and the doctor-patient relationship: the need for a better linkage. In: Gillon R (ed.). Principles of health care ethics. New York: John Willey; 1994: p.354.
Pellegrino ED. The metamorphosis of medical ethics. JAMA. 1993; 269(9):1158-62.
Carta Internacional dos Direitos Humanos. Declaração Universal dos Direitos do Homem: Adotada e proclamada pela Assembleia Geral na sua Resolução 217A (III); 10 de Dezembro de 1948.
Conselho da Europa. Convenção para a Proteção dos Direitos do Homem e da Dignidade do Ser Humano face à s Aplicações da Biologia e da Medicina: Adoptada e aberta à assinatura em Oviedo; 4 de Abril de 1997.
Pellegrino ED, Thomasma DC. The virtues in medical practice. New York: Oxford University Press; 1993: p.169.
Pellegrino ED, Thomasma DC. A philosophical basis of medical practice: toward a philosophy and ethic of the healing professions. New York: Oxford University Press; 1981: p.248.
Relman AS. Profit and Commercialism. In: Post SG (Ed.). Encyclopedia of Bioethics (3a ed). New York; Thomson Gale 2004, vol (4): 2171.
Pellegrino ED. The commodification of medical and health care: The moral consequences of a paradigm shift from a professional to a market ethic. J Med Phil 1999; 24 (3): 243-66.
Platão. A República (12a ed). Fundação Calouste Gulbenkian; Lisboa, 2010.p. 20.
Serrão D. A ética médica e os custos dos cuidados de saúde, In: Serrão D, Nunes R. (Coord.). Ética em cuidados de saúde. Porto: Porto, 1998. p.156.
Veatch RM. Patient, heal thyself: how the new medicine puts the patient in charge. New York; Oxford University Press 2009: VII-VIII.
Pellegrino ED. The moral foundations of the patient-physician relationship: the essence of medical ethics in military medical ethics. In: Beam TE, Sparacino L (Eds.). Textbooks of military medicine (Vol. 1). Washington DC. US Army, Office of the Surgeon General; 2003:p. 9.
Da Gama AD. O declínio do estatuto médico no início do milénio. Rev Port Cir CardioTorac Vasc 2008; 10(4): 185-86.
Lupton D. Consumerism, reflexivity and the medical encounter. Soc Sci Med 1997; 45(3): 373-81.
Laín-Entralgo P. El médico y el enfermo (2a ed). Madrid; Triacastela 2003: 183.
Pellegrino ED. Edmund Pellegrino: critical thinker. Physician 1998; 10(4): 14-17.
Pellegrino ED. Moral choice, the good of the patient, and the patient’s good. In: Moskop JC, Kopelman L (Eds). Ethics and critical care medicine. Dordrecht, Holland; Reidel 1985: 122.
Pellegrino ED. The internal morality of clinical medicine: a paradigm for the ethics of the helping and healing professions. J Med Philos 2001; 26: 559-79.
