Bien que ce livre contienne, pour le médecin du xxie siècle, de précieuses leçons qui portent à la réflexion, il présente aussi un intérêt majeur pour le patient lui-même. Dans cette perspective, ...donner comme recevoir des soins de santé de qualité dépend d’une relation médecin-patient fondée sur l’humanisme.Si le récit de l’expérience professionnelle du Dr Hadler se passe en territoire américain, l’humanisme de celui-ci veut transcender les frontières en ajoutant aux valeurs morales de toute société humaine.Il faut saluer le courage de l’auteur qui aborde des questions dérangeantes. Avec une ferme conviction et une grande éloquence, il multiplie ses efforts afin de mieux nous inciter à saisir l’importance de la relation médecin-patient dans le processus de guérison.Nortin M. Hadler, M.D., M.A.C.P., M.C.R., F.A.C.O.E.M., est diplômé du collège de Yale et de l’École de médecine de Harvard. Professeur émérite de médecine et de microbiologie à l’École de médecine de l’Université de Caroline du Nord, il est l’auteur de 200 articles et de 12 ouvrages. Sur le plan international, il se distingue par ses positions très critiques contre le surdiagnostic et le surtraitement en prônant une approche thérapeutique plus humaniste.
Physicians recognize the importance of patients' emotions in healing yet believe their own emotional responses represent lapses in objectivity. Patients complain that physicians are too detached. The ...book argues that by empathizing with patients, rather than detaching, physicians can best help them. Yet there is no consistent view of what, precisely, clinical empathy involves. This book challenges the traditional assumption that empathy is either purely intellectual or an expression of sympathy. Sympathy, according to many physicians, involves over-identifying with patients, threatening objectivity and respect for patient autonomy. How can doctors use empathy in diagnosing and treating patients without jeopardizing objectivity or projecting their values onto patients? The book develops an account of emotional reasoning as the core of clinical empathy. It argues that empathy cannot be based on detached reasoning because it involves emotional skills, including associating with another person's images and spontaneously following another's mood shifts. Yet it argues that these emotional links need not lead to over-identifying with patients or other lapses in rationality but rather can inform medical judgement in ways that detached reasoning cannot. For reflective physicians and discerning patients, this book provides a road map for cultivating empathy in medical practice. For a more general audience, it addresses a basic human question: how can one person's emotions lead to an understanding of how another person is feeling?
After Harm Berlinger, Nancy
2005, 2007-10-22, 20050101
eBook
Medical error is a leading problem of health care in the United States. Each year, more patients die as a result of medical mistakes than are killed by motor vehicle accidents, breast cancer, or ...AIDS.
While most government and regulatory efforts are directed toward reducing and preventing errors, the actions that should follow the injury or death of a patient are still hotly debated. According to Nancy Berlinger, conversations on patient safety are missing several important components: religious voices, traditions, and models.
In After Harm, Berlinger draws on sources in theology, ethics, religion, and culture to create a practical and comprehensive approach to addressing the needs of patients, families, and clinicians affected by medical error. She emphasizes the importance of acknowledging fallibility, telling the truth, confronting feelings of guilt and shame, and providing just compensation. After Harm adds important human dimensions to an issue that has profound consequences for patients and health care providers.
Autism has attracted a great deal of attention in recent years, thanks to dramatically increasing rates of diagnosis, extensive organizational mobilization, journalistic coverage, biomedical ...research, and clinical innovation. Understanding Autism, a social history of the expanding diagnostic category of this contested illness, takes a close look at the role of emotion--specifically, of parental love--in the intense and passionate work of biomedical communities investigating autism.
In the nineteenth century, infants were commonly breast-fed; by the middle of the twentieth century, women typically bottle-fed their babies on the advice of their doctors.  In this book, Rima ...D. Apple discloses and analyzes the complex interactions of science, medicine, economics, and culture that underlie this dramatic shift in infant-care practices and women’s lives.     As infant feeding became the keystone of the emerging specialty of pediatrics in the twentieth century, the manufacture of infant food became a lucrative industry.  More and more mothers reported difficulty in nursing their babies.  While physicians were establishing themselves and the scientific experts and the infant-food industry was hawking the scientific bases of their products, women embraced “scientific motherhood,” believing that science could shape child care practices.  The commercialization and medicalization of infant care established an environment that made bottle feeding not only less feared by many mothers, but indeed “natural” and “necessary.”  Focusing on the history of infant feeding, this book clarifies the major elements involved in the complex and sometimes contradictory interaction between women and the medical profession, revealing much about the changing roles of mothers and physicians in American society. “The strength of Apple’s book is her ability to indicate how the mutual interests of mothers, doctors, and manufacturers led to the transformation of infant feeding. . . . Historians of science will be impressed with the way she probes the connections between the medical profession and the manufacturers and with her ability to demonstrate how medical theories were translated into medical practice.”—Janet Golden, Isis  
The troubling increase in treatment resistance in psychiatry has many culprits: the rise of biomedical psychiatry and corresponding sidelining of psychodynamic and psychosocial factors; the increased ...emphasis on treating the symptoms rather than the person; and a greater focus on the electronic medical record rather than the patient, all of which point to a breakdown in the person-centered prescriber-patient relationship. Psychodynamic Psychopharmacology illuminates a new path forward. It examines the psychological and interpersonal mechanisms of pharmacological treatment resistance, integrating research on evidence-based prescribing processes with psychodynamic insights and skills to enhance treatment outcomes for patients who are difficult to treat. The first part of the book explores the evidence base that guides how, rather than simply what, to prescribe. It describes precisely what psychodynamic psychopharmacology is and why its emphasis on combining the often-neglected psychosocial aspects of medication with biomedical considerations provides a more optimized approach to addressing treatment resistance. Part II delves into the psychodynamics that contribute to pharmacological treatment resistance, both when patients' ambivalence about their illness, the medication itself, or their prescriber manifests in nonadherence and when medications support a negative identity or are used as replacements for healthy capacities. Readers will gain basic skills for addressing the psychological and interpersonal dynamics that underpin both scenarios and will be better positioned to ameliorate interferences with the healthy use of medications. The final section of the book offers detailed technical recommendations for addressing pharmacological treatment resistance. It tackles issues that include countertransference-driven irrational prescribing; primitive dynamics, such as splitting and projective identification; and the overlap between psychopharmacological treatment resistance and the dynamics of treatment nonadherence and nonresponse in integrated and collaborative medical care settings. By putting the individual patient back at the center of the therapeutic equation, psychodynamic psychopharmacology, as outlined in this book, offers a model that moves beyond compliance and emphasizes instead the alliance between patient and prescriber. In doing so, it empowers patients to become more active contributors in their own recovery.
Psychiatry Stringer, Sarah L; Hurn, Juliet; Burnside, Anna M
2015, 2015-09-21
eBook
Psychiatry: Breaking the ICE contains everything psychiatry trainees need in order feel confident and competent in general adult inpatient and community placements. * A practical and reassuring guide ...to life as a psychiatrist, structured around the tasks expected both in day-to-day practice and in out-of-hours work * Key themes running throughout the book include ethical and legal issues, risk assessment and management, patient experience and safe prescribing * The authors are closely involved in the training, mentoring and supervision of core trainees, and know the real-world challenges faced by junior psychiatrists
For many doctors, their role as powerful healer precludes thoughts of ever getting sick themselves. When they do, it initiates a profound shift of awareness – not only in their sense of their selves, ...which is invariably bound up with the ‘invincible doctor’ role, but in the way that they view their patients and the doctor-patient relationship. While some books have been written from first-person perspectives on doctors who get sick, never has there been a systematic, integrated look at what the experience is like for doctors who get sick, and what it can teach us about our current health care system and more broadly, the experience of becoming ill. The psychiatrist Robert Klitzman here weaves together gripping first-person accounts of the experience of doctors who fall ill and see the other side of the coin, as a patient. The accounts reveal how dramatic this transformation can be – a spiritual journey for some, a radical change of identity for others, and for some a new way of looking at the risks and benefits of treatment options. For most however it forever changes the way they treat their own patients. These questions are important not just on a human interest level, but for what they teach us about medicine today. While medical technology advances, the health care system itself has become more complex and frustrating, and physician-patient trust is at an all-time low. The experiences offered here are unique resource that point the way to a more humane future.
