Medical Ethics

Medical ethics is based on the clinician-patient relationship. One of the most interesting aspects of medical care is the way in which clinicians and patients communicate with one another. Good relationship is associated with improved physical health.

Clinician-Patient Relationship

Clinician-patient relationship can help the patient understand how to follow a complex medication regimen. This type of communication can also affect motivational and cognitive processes initiating health-related behaviors such as smoking, diet and exercise. These behavior processes must be supported by the social environment. Moreover, there are six clinician-patient communication functions in relation to ethics:

• Fostering healing relationship is the first function: the physician assists patients in helping themselves; the patient participates in decision making.
• Information exchange is the second function: in this case, the patient’s understanding of medical information enhances memory; memory and understanding increase patient satisfaction; satisfaction increases compliance.
• Responding to emotions is the third function; we can identify four dimensions of emotional communication: intimacy, affection-hostility, emotional arousal, and composure.
• Managing uncertainty is the fourth function; uncertainty is experienced when aspects of the illness, treatment and recovery are perceived as inconsistent, random, complex and unpredictable; physicians can reduce uncertainty by alleviating anxiety.
• Making decisions is the fifth communication function; there are three types of medical decision making: paternalistic, shared and informed; and each of these types consists of three phases: information exchange, deliberation and decision.
• Enabling patient self-management is the sixth communication function; in this case, health behavior is a function of attitudes, social norms and self-efficacy which come from control beliefs.

Strong versus Weak Points

From these six functions, we can deduce the strong points of the relationship between clinician and patient. Each function reveals at least one strong point. This type of communication establishes and maintains the physician-patient relationship ethical. It also helps the physician and the patient exchange information about each other. The interpersonal communication helps the doctor be empathic and understand the patient’s emotional reactions to his or her health problems. There is a weakness of this theory: if one of the partners is not sincere and empathic, all these benefits will disappear.

Studies of patients’ experiences over time should be completed using designs of physicians nested within patients. Communication measures should be theory-based and empirically validated, reflecting medical ethics. The researchers should also study the influences of various factors on communication and health outcomes. In the future, researchers should be guided by and develop theoretical models linking the communication process to health outcomes.