Educating Judgement - Chapter 6
According to Downie and Macnaughton, technical judgement is rooted in specialized knowledge
and skills obtained through medical education.
- the knowledge consists of the generilized knowledge of medical research that must be
individualized to the patient
- the skills include practical skills, communication skills, and negotiating consent.
- technical judgement determines medical good
According to Downie and Macnauhgton, the other important part of the clinical judgement is
- a patient medical good is only part of their total good
- there is a tendency for practitioners to medicalize situation by viewing medical good as total
Humane judgemente involves recognizing that a patients's total good is determined in a broader
context known only by patient.
• A history - a before and after medical relationship
• A geography - areas of life that have nothing to do with the medical relationship
As they write :
"The doctor must deal with patients, or in other words, with persons in certain restricted aspects
of their total existence."
Specialized knowledge and skills
Education in Medical Subjects
Education in which subjects? Specialized knowledge and skills
What sort of knowledge?
Person "history" and "geography"
Medical educators would agree that clinical practice requires na ethical sensitivity
However, Downie and Macnaughton argue that the concept of a humane doctor is wider than
that of na ethica doctor.
• A humane doctor has na educated perspective
All occupation involve skills and knowledge of some sort.
• A good accountant is someone who has good accounting skills.
• However, it is entirely possible to have good skills, but not be morarlly good.
• A good doctor also has special skills and knowledge
• Are there moral qualities that are required by the doctor in his role as doctors?
• According to Plato, no special moral qualities are required
a good doctor can be a good poisoner, says Plato.
• The modern tradition of taking a Hipocratic Oath reflects this history.
However, Downie and Macnaughton note that today, it is accpepted that a doctor does need
moral qualities, such as:
• A desire to avoid harming the patient.
• A desire to help the paient
• A desire to act justly
• A desire to respect the patient's decisions
But, these qualities are not speci