Consultation instead of prescription—a model for the structure of the doctor–patient relationship

Poiesis and Praxis 2 (1):1-27 (2003)

Against the usual paternalism, this article develops the proposition to structure the interaction between the doctor and the patient as an inter-subjective consultation. This means that the "information" of the patient prior to treatment, when "informed consent" is secured, as well as the actual medical treatment would have to be turned into an interaction between two responsible individuals. The "irresponsibility" of this patient, which is supposed to result from his "uninformedness", as is often argued in favour of keeping to paternalism, does not have to lead to an interaction model of prescription and compliance. Even for the interaction with patients who are unable to understand or consent, the concept of dialogical interaction must be maintained counterfactually; it has only to be supplemented by the variant of "tutorial action". The prescriptive model of behaviour is extended by the obligation—even when the doctor is the sole decision maker—of acting in the well-understood self-interest of the patient and, if necessary, of providing evidence for this orientation of the treatment. Thus, the model of dialogical interaction is shown to be the comprehensive model, because it covers the interests of the doctor and of the patient
Keywords No keywords specified (fix it)
Categories (categorize this paper)
DOI 10.1007/s10202-003-0036-3
Edit this record
Mark as duplicate
Export citation
Find it on Scholar
Request removal from index
Revision history

Download options

Our Archive

Upload a copy of this paper     Check publisher's policy     Papers currently archived: 44,253
External links

Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
Through your library

References found in this work BETA

How We Die: Reflections on Life's Final Chapter.Sherwin B. Nuland - 1994 - Published by Random House Large Print in Association with Alfred A. Knopf.

Add more references

Citations of this work BETA

No citations found.

Add more citations

Similar books and articles

Three Stages of Medical Dialogue.Henry Abramovitch & Eliezer Schwartz - 1996 - Theoretical Medicine and Bioethics 17 (2).
Medicine as a Trade.Marian Rabinowitz - 1980 - Theoretical Medicine and Bioethics 1 (3):255-261.
Doctor-Family-Patient Relationship: The Chinese Paradigm of Informed Consent.Yali Cong - 2004 - Journal of Medicine and Philosophy 29 (2):149 – 178.
The Doctor–Patient Relationship.Harry H. Gordon - 1983 - Journal of Medicine and Philosophy 8 (3):243-256.
The Silent World of Doctor and Patient.Jay Katz - 1984 - Johns Hopkins University Press.
Teaching Argumentation Theory to Doctors: Why and What.Sara Rubinelli & Claudia Zanini - 2012 - Journal of Argumentation in Context 1 (1):66-80.
Boundaries in the Doctor–Patient Relationship.Carol Nadelson & Malkah T. Notman - 2002 - Theoretical Medicine and Bioethics 23 (3):191-201.
The Noncompliant Patient: A Kantian and Levinasian Response.P. Burcher - 2012 - Journal of Medicine and Philosophy 37 (1):74-89.


Added to PP index

Total views
16 ( #529,385 of 2,269,775 )

Recent downloads (6 months)
1 ( #835,177 of 2,269,775 )

How can I increase my downloads?


My notes

Sign in to use this feature