نوع مقاله : پژوهشی

نویسندگان

1 دانشجوی پزشکی، دانشگاه علوم پزشکی اصفهان، شرکت کننده یازدهمین دوره المپیاد دانشجویی پزشکی حیطه علوم انسانی سلامت

2 دانشجوی پزشکی، دانشگاه علوم پزشکی شهید صدوقی یزد، شرکت کننده یازدهمین دوره المپیاد دانشجویی پزشکی حیطه علوم انسانی سلامت

چکیده

در این مقاله ابتدا تلاش می‌کنیم با مروری بر سیر تاریخی پزشکی، دلیل مطرح‌شدن و کاربرد مفهوم همدلی بالینی در پزشکی را یافته و سپس ایرادات نظری این مفهوم که مانع رسیدن به بیناذهنیت و درک صحیح شده‌اند را ذکرکنیم؛ این ایرادات موارد پیش‌رو را شامل می‌شوند: عدم توجه به ذهنیت‌های پزشک و بیمار، عدم توجه به پویایی مفهوم همدلی و عدم توجه به وابستگی مفهوم همدلی به بافتار. سپس پیامدهای بالقوه نامطلوب کاربرد آن، یعنی کمک به تقویت قیم‌مآبی، اثرات نامطلوب برای طبابت و ابزاری جایگزین برای کمبود بودجه و حفظ قدرت سیاسی دولت‌ها را مطرح خواهیم‌کرد. بعد از آن با بهره‌گیری از نظرات فیلسوفان (به خصوص متفکران سنت پدیدارشناختی) و سیر علوم انسانی پزشکی، با استفاده از رویکردی بینارشته‌ای استدلال خواهیم‌کرد که چرا مفهوم همدلی در پزشکی نیازمند بازنگری است و لازم است هم‌راستا با موج دوم علوم انسانی پزشکی حرکت کند و با محور قرار‌دادن فلسفه موجب گردد تا درک صحیح از بیمار بار دیگر در مفهوم پزشکی تنیده شود.

کلیدواژه‌ها

عنوان مقاله [English]

Phenomenological review of empathy in medicine: A critical review

نویسندگان [English]

  • Aryan Kavosh 1
  • Faraz Golafshan 1
  • Nazanin Soleimani 2
  • Seyedeh parnian Hosseini kazerouni 1

1 Medical student at Isfahan university of medical sciences, participant in 11th Olympiad in medical humanities

2 Yazd Shahid Sadoughi University of Medical Sciences و participant in 11th Olympiad in medical humanities

چکیده [English]

From a phenomenological perspective, we review the concept of empathy in medicine to identify the theoretical obstacles which have prevented reaching intersubjectivity and proper understanding. Where medicine has failed are: attending to subjectivities of patient and physician, recognizing the dynamic nature of empathy and acknowledging context-dependency of empathy. We also review the problematic practical consequences of this theoretical failure including serving medical paternalism, hindering medical practice, and being used as a tool for counterbalancing inadequate health budget and serving political power. Thus, using and interdisciplinary approach, we argue why the concept of empathy in medicine needs to be reviewed under the light of phenomenology and progress in line with second wave of medical humanities; put philosophy at its core to once again integrate proper understanding of the patient with the concept of medicine .

کلیدواژه‌ها [English]

  • empathy
  • medicine
  • phenomenology
  • intersubjectivity
  • medical humanities
منجمی، علی‌رضا ( ۱۳۸۵)، «آیا علوم‌انسانی پزشکی یک رویکرد بینارشته‌ای است؟»، در: مجموعهمقالات کنگرۀ ملی علوم ‌انسانی، پژوهشگاه علوم انسانی و مطالعات فرهنگی.
Agosta, L. (1984), "Empathy and Intersubjectivity Empathy", in: Empathy 1, Joseph Lichtenberg and Donald Silver (eds.), New Jersey: The Analytic Press.
Aring, C. D. (1958), "Sympathy and Empathy", Journal of the American Medical Association, vol. 167, no. 4.
Aron, L. (2013), A meeting of Minds: Mutuality in Psychoanalysis, New York: Routledge.
Auger, J.F. (2008), Systematic Reviews in the Social Sciences: a Practical Guide, Mark Petticrew, Helen Roberts (eds.), Oxford: Wiley-Blackwell.
Bærøe, K. (2015), "Medicine as Art and Science", in: Handbook of the Philosophy of Medicine, Thomas Schramme and Steven Edwards (eds.), Dordrecht: Springer.
Bellet, P. S., and M. J. Maloney (1991), "The Importance of Empathy as an Interviewing Skill In Medicine", Jama, vol. 266, no. 13.
Benjamin, J. (1998), Shadow of the Other; Intersubjectivity and Gender in Psychoanalysis, New York: Routledge.
Beres, D. and J. A. Arlow (1974), "Fantasy and Identification in Empathy", The Psychoanalytic, vol. 43, no.1.
Betzler, R. J. (2018), "How to Clarify the Aims of Empathy in Medicine", Medicine, Health, Care and Philosophy, vol. 21. no. 4.
Bleakley, A. (2015), Medical Humanities and Medical Education: How the Medical Humanities Can Shape Better Doctors, New York: Routledge.
Chalmers, D. J. (2002), Philosophy of Mind: Classical and Contemporary Readings, Oxford: Oxford University Press.
Cooper-White, P. (2014), "Intersubjectivity", Encyclopedia of Psychology and Religion.
Coplan, A. and P. Goldie (2011), Empathy; Philosophical and Psychological Perspectives, Oxford: Oxford University Press.
Cowley, C. (2005), "The Dangers of Medical Ethics", Journal of Medical Ethics, vol. 31, no. 12.
Cuff, B. M. et al. (2016), "Empathy: a Review Of The Concept, Emotion Review, vol. 8, no. 2.
De Waal, F. (2010), The Age of Empathy: Nature's Lessons for a Kinder Society, Broadway Books.
Dworkin, G. (1972), "Paternalism", The Monist, vol. 56, no. 1.
Engel, G. L. (1977), "The Need for A New Medical Model: A Challenge for Biomedicine", Science, vol. 196, no. 4286.
Foucault, M. (1973), The Birth of The Clinic: An Archaeology of Medical Perception, trans. AM Sheridan Smith, New York: Pantheon.
Gallagher, S., and Zahavi, D. (2013), The Phenomenological Mind, New York: Routledge.
Garden, R. (2007), "The Problem of Empathy: Medicine and the Humanities", New Literary History, vol. 38, no. 3.
Gelhaus, P. (2012), "The Desired Moral Attitude of the Physician: (I) Empathy", Medicine, Health Care and Philosophy, vol. 15, no. 2.
Halpern, J. (2001), From Detached Concern To Empathy: Humanizing Medical Practice, Oxford: Oxford University Press.
Halpern, J. (2003), "What Is Clinical Empathy?" Journal of General Internal Medicine, vol. 18, no. 8.
Haque, O. S. and A. Waytz (2012), "Dehumanization in Medicine: Causes, Solutions, and Functions", Perspectives on Psychological Science, vol. 7, no. 2.
Hayward, R. (2005), "Empathy", The Lancet, vol. 366, no. 9491.
Hojat, M. et al. (2011), "Physicians' Empathy and Clinical Outcomes for Diabetic Patients", Academic Medicine, vol. 86, no. 3.
Hooker, C. (2015), "Understanding Empathy: Why Phenomenology and Hermeneutics Can Help Medical Education and Practice", Medicine, Health Care, and Philosophy, vol. 18, no. 4.
Jeffrey, D. (2016), "Empathy, Sympathy, and Compassion in Healthcare: Is There a Problem? is There a Difference? Does it Matter?" Journal of the Royal Society of Medicine, vol. 109, no. 12.
Lakoff, G. and M. Johnson (2008), Metaphors We Live by, Chicago: University of Chicago press.
Macnaughton, J. (2009), "The Dangerous Practice Of Empathy", The Lancet, vol. 373, no. 9679.
Marshall, R. and A. Bleakley (2009), "The Death Of Hector: Pity In Homer, Empathy In Medical Education", Medical Humanities, vol. 35, no. 1.
Morse, J. M. et al. (1992), "Exploring Empathy: a Conceptual Fit for Nursing Practice?", The Journal of Nursing Scholarship, vol. 24, no. 4.
Ogden, T. (1994), Subjects of Analysis, New Jersey: Jason Aronson Book.
Pedersen, R. (2008), "Empathy: A Wolf In Sheep’s Clothing?" , Medicine, Health Care, and Philosophy, vol. 11, no. 3.
Pellegrino, E. D. (1979), Humanism and the Physician, Knoxville: University of Tennessee Press.
Polaschek, D. L. (2003), "Empathy and Victim Empathy", in: T. Ward, D. R. Laws, and S. M. Hudson (eds.), Sexual Deviance; Issues and Controversies, SAGE Publications.
Rothman, D. J. (2017), Strangers at the Bedside: a History of How Law and Bioethics Transformed Medical Decision Making, New York: Routledge.
Schramme, T. (2017), Goals of Medicine; Handbook of the Philosophy of Medicine, Springer.
Slaby, J. (2014), "Empathy’s Blind Spot", Medicine, Health Care, and Philosophy, vol. 17, no. 2.
Spiro, H. et al. (1996), Empathy and the Practice of Medicine: Beyond Pills and the Scalpel, New Haven: Yale University Press.
Stanghellini, G., & Rosfort, R. (2013), "Empathy as a Sense of Autonomy", Psychopathology, vol. 46, no. 5.
Stein, E. (1989), On the Problem of Empathy, trans. Waltraut Stein, Collected Works of Edith Stein, vol. 3.
Stempsey, W. E. (2007), "Medical Humanities and Philosophy: Is The Universe Expanding Or Contracting?" Medicine, Health Care, and Philosophy, vol. 10, no. 4.
Stueber, Karsten (2019), "Empathy", The Stanford Encyclopedia of Philosophy, Edward N. Zalta (ed.), <https://plato.stanford.edu/archives/fall2019/entries/empathy/>.
Svenaeus, F. (2014), "The Phenomenology of Empathy in Medicine: an Introduction, Medicine, Health Care and Philosophy, vol. 17, no. 2.