Masters Degrees (Philosophy)

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Browsing Masters Degrees (Philosophy) by Author "Broekmann, Reginald J. (Reginald John)"

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    Power in the physician-patient relationship
    (Stellenbosch : Stellenbosch University, 2000-04) Broekmann, Reginald J. (Reginald John); Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Philosophy.
    ENGLISH ABSTRACT: This paper examines aspects of power within the physicianpatient relationship. The historical development of the physician-patient relationship is briefly reviewed and some of the complexities of the relationship highlighted. It is shown that, historically, there is no imperative for the physician to consider only the interests of the patient and it has always been acceptable to consider the interests of a third party, such as the State or an employer - essentially the interests of whoever is paying the physician. The classical sources of power are then considered. These sources include legitimate power, coercive power, information power, reward power, expert power, referent power, economic power, indirect power, associative power, group power, resource power and gender power. Other approaches to power are also considered such as principle-centred power as described by Covey, power relationships as explained by Foucault, the power experience as described by McClelland and an analysis of power as expounded by Morriss. The various sources of power are then considered specifically within the physician-patient relationship to determine: if this particular type of power is operative in the physicianpatient relationship, and if so if it operates primarily to the advantage of the physician or the advantage of the patient. A simple method of quantifying power is proposed. Each form of power operative in the physician-patient relationship is then considered and graphically depicted in the form of a bar chart. Each form of power is shown as a bar and bars are added to the chart to 'build up' an argument which demonstrates the extent of the power disparity between physician and patient. It is clearly demonstrated that all forms of power operate to the advantage of the physician and in those rare circumstances where the patient is able to mobilize power to his/her advantage, the physician quickly calls on other sources of power to re-establish the usual, comfortable, power distance. Forms of abuse of power are mentioned. Finally, the ethical consequences of the power disparity are briefly considered. Concern is expressed that the power disparity exists at all but this is offset by the apparent need for society to empower physicians. Conversely, consideration is given to various societal developments which are intended to disempower physicians, particularly at the level of the general practitioner. Various suggestions are made as to how the power relationships will develop in future with or without conscious effort by the profession to change the relationship.