An analytic review of the doctor-patient relationship part I

Liviu Oprea

Abstract


In this article I review of the bioethics and clinical models of doctor-patient relationship and analyze them with ethical lens. It has two parts. First I review the bioethics models of DPR and argue that they are normative and prescriptive in nature being derived from various ethical and social theories. Although they describe various processes through which they may promote either patients’ autonomy or beneficence, these processes are not assessed empirically and, therefore, it is not clear whether their implementation at the level of health systems may rich their goals. Second, I review the clinical models of DPR and show that similar to the bioethics models of DPR they are normative and prescriptive in nature. In addition, similar to the bioethics models of DPR, they are instrumental for beneficence and patients’ autonomy. However, the processes through which these models aim at promoting beneficence were comprehensively assessed from an empirical point of view. I outline this research and argue that there is evidence that the relationship centered care model of DPR may promote beneficence and patients’ autonomy if implemented. Finally, I compare the processes in the clinical models of DPR with those in the bioethics models and argue that the contractual models of DPR are likely to promote less beneficence and patients’ autonomy as compared with relational models of DPR.

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