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Beyond Empathy: Teaching Alterity

机译:超越同理心:教导改变

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Clinical empathy has been increasingly recognized as an important component of both professionalism and good patient care. It is generally understood as identifying commonality between patient and provider and responding to this shared experience with appropriate care and concern. However, many clinical encounters are between strangers with little shared experience, which seems to present a challenge for both empathy and a sense of responsibility toward the patient. Physicians can also develop a deep sense of caring and responsibility by learning to appreciate the alterity, the otherness, of the patient, and this skill, like clinical empathy can be modeled and taught. Philosopher Emmanuel Levinas described respect for alterity as foundational to human relationships. That is, my primary experience in meeting other people is one of difference, not an immediate sense of similarity. This sense of difference is both superficial and profound, although in most cases we will recognize only the superficial. Recognizing the profundity of difference opens one up to a radical sense of alterity that is the source of ethics, including our responsibility to the other. By exploring Levinas’ descriptions of human responsibility, humans as infinite and unique, and the consequences of this philosophy for the clinical encounter, it is evident that respect for alterity represents an underappreciated source of human caring, accessible in clinical relationships, even between a patient and physician with radically different life experiences. The implications of this for medical education are that we must help students appreciate and respect both the commonality we share with our patients, and the differences that makes them special and worthy of our care and attention.
机译:临床同理心已日益被公认为是专业精神和良好患者护理的重要组成部分。通常将其理解为识别患者和提供者之间的共性,并在适当护理和关注下响应这种共享的经验。但是,许多临床遭遇是在陌生人之间,几乎没有共同经验,这似乎对同理心和对患者的责任感都构成了挑战。医师还可以通过学会欣赏患者的变化,与众不同的方式,来培养深切的关怀和责任感,并且可以模拟和教授这种技能,例如临床共情。哲学家艾曼纽尔·列维纳斯(Emmanuel Levinas)将尊重变化视为人类关系的基础。也就是说,我在与其他人会面的主要经验是差异之一,而不是直接的相似感。这种差异感既是肤浅的,也是深刻的,尽管在大多数情况下,我们只会认识到肤浅的。认识到差异的深远性会导致一种根本的改变感,这种改变是道德的根源,包括我们对另一种责任。通过探索列维纳斯关于人类责任,人类是无限和独特的描述,以及这种哲学对临床遭遇的后果,很明显,对改变的尊重代表了人们对人类关怀的重视程度低,在临床关系中,甚至在患者之间也可以使用和医生有着截然不同的生活经历。这样做对医学教育的意义在于,我们必须帮助学生欣赏和尊重我们与患者共享的共性,以及使他们与众不同并值得我们关注和关注的差异。

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