HS4091 CHapter 6 - Educating Judgement

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Western University
Health Sciences
Health Sciences 2711A/B
Aleksandra Zecevic

Educating Judgement - Chapter 6 March-27-14 8:28 AM 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 humane judgement. - 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 good. 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." Education in Medical Subjects Clinical Judgement Specialized knowledge and skills Medical good Education in Medical Subjects Clinical Judgement Education in which subjects? Specialized knowledge and skills Humane judgement What sort of knowledge? Medical good Total good 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
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