UNIT 7 Doctor-patient Relationship Teaching Objectives
After learning Unit 7, Ss are expected to accomplish the following objectives:
Teaching Activities and Resources
Part 1 Reading
Text A
Lead-in
Suggested teaching plan
1. Doctor-patient relationship is among the most controversial focus and most
widely talked about in medical and healthcare communities. It is a determinant factor of quality care. On the part of language, words are sometimes value-laden and posss magic power. The same relationship can be differently connoted by using different terms. Before starting the class, it is advisable to know the implications of the terms: doctor, physician, medical practitioner, provider and patient, client, customer.
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Doctor: referring to a “teacher” to show, to teach, or to appear right, and carrying
a connotation of being emly fitting and decent
Physician: denoting a practitioner of the art of healing
Medical practitioner: a technique term without much connotation
Provider: a generic term more or less related to business
Patient: indicating a suffering or sick person under medical treatment
Client: referring to a person who is willing to pay for goods or rvices
Customer: denoting one who buys goods or rvices香港港督
Awareness of the subtleties as incurred by the u of the different terms to indicate the doctor-patient relationship will contribute to a better understanding of the characteristics of an amicable and ideal doctor-patient relationship.
2. Lead Ss to do Task / Lead-in.
1) Ask Ss to think of at least three different situations where doctors may be
asked to make “tough decisions” for their patients.
•Decide whether life-support system should be continued or withdrawn.
•Decide whether euthanasia should be taken into consideration.
•Decide whether a new therapy should be tried.
•Decide whether surgery should be the first choice or the last resort.
•Decide whether transfer or referral is needed.
2) Have a quick check and a short discussion on what Ss have come up with.
3. Make a summary on the discussion and introduce the topic of Text A.
Text Comprehension
Suggested teaching plan
1.Launch the topic of the text as a continuum of Lead-in.
2.Analyze the text and lead Ss to discuss, integrating Task 2 / Critical reading
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and thinking / Text A into analysis and discussion. The prentation topics should be assigned to individual Ss for preparation at least one week in advance.
Ask other Ss to preview the text with the guidance of the prentation topics.
3.Lead Ss to do Task 2 / Language building-up / Text A after a discussion of the
text.
4.When analyzing the text, ask Ss to pay special attention to the ntences listed in
Language focus below.
5.If time allows, ask Ss to do Task 1 / Critical reading and thinking / Text A in
about five minutes. Check out the task by asking one or two Ss to read their answers. This is done to get an overview about the text.
Language focus
1.He was large and powerfully built … miraculously shrinking down to their
eye level whenever he spoke with them. (P164, Para. 1)
句子运用了对比的手法（large and powerfully built / shrink down to their eye level），有利于加强文章的艺术效果和感染力。
2.… that interpretation would work its way into the teaching programs of
medical schools and into state laws that mandated discussion of treatment options with patients. (P165, Para. 6)
work its way into意为“努力进入，深入……”，在此强调这是一个漫长的过程。
3.While the doctors might be convinced that they are being objective and
dispassionate, more often than not they are nding mixed messages.(P166, Para. 12)
be convinced that they are being objective and dispassionate运用了“are being +形容词”这个结构，表示强调，意为“坚信如此”。
4.But that doctor may also u value-laden language to describe the options.
什么食物可以美白(P166, Para. 13)
观点是带有个人价值的判断，反映了个人的某种态度或倾向，它是价值负载的（value-laden）。value-laden words也称为loaded words。
Supplementary information
Etymologically, “paternalism”comes from Latin patern-(father). It literally means acting like a father, or treating another person like a child. To treat a person paternalistically is to treat him in a way that ignores or discounts his wishes but aims at promoting the person’s best interest. In medical decision-making, the relationship between the doctor and the patient in the paternalistic approach is analogous to that between the father and the child.
The word “autonomy”comes from Latin auto-(lf). Its literal meaning is independence or living on one’s own rule. In a medical context, respect for a patient’s autonomy is considered a fundamental ethical principle, and this belief is the central premi of the concept of informed connt.
There is, so far, no connsus on how much autonomy should be granted to the patient concerning
medical decisions. In most cas, a compromi has to be made between the two paradigms, leaving room for and balancing between paternalism and autonomy.
2. four models of the doctor-patient relationship
Four models are generally identified in doctor-patient relationship: the paternalistic model, the informative model, the interpretive model, and the deliberative model.
In the paternalistic model, the doctor holds an authoritative role and the best interests of the patient as judged by the clinical experts are valued above the provision of comprehensive medical information and decision-making power for the patient.
An informative doctor-patient relationship, by contrast, consists of a doctor disclosing all information associated with the patient and their diagnosis, and es the patient as a consumer who is in the best position to judge what is in their own interest, and thus views the doctor as chiefly a provider of information.
In the interpretive model, the doctor provides all relevant information to the patient concerning their diagnosis and intervention options and then helps the patient lect the available medical interventions.
The final doctor-patient relationship model is referred as the deliberative model, which confines the doctor’s focus to only health-related principles. That is, the doctor helps the patient determine and choo the best health-related values that can be realized in the clinical situation.
The four models can be summarized in the table below:
Key to the tasks
Critical reading and thinking
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Task 1
1)paternalistic
2)patient-centered
审计总结>东方威尼斯是哪个城市3)the person
4)the person’s autonomy
5)physician restraint
6)doctors making final decisions
7)the stressful situation
迅捷wifi8)dishonesty in communication
9)respecting their opinions and shouldering the responsibility together
Task 2
1.
∙ A dying patient
∙Decision whether to withdraw life-support machines and medications and start comfort measures
∙The family’s refusal to make any decision s or withdraw any treatments
