Testing the Medical Covenant: Caring for Patients with Advanced Dementia
Testing the Medical Covenant: Caring for Patients with Advanced Dementia
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测试医疗契约：照顾晚期痴呆症患者
DOI：
10.1111/j.1748-720x.2012.00644.x
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发表时间：
2012
期刊：
影响因子：
--
通讯作者：
W. May
中科院分区：
文献类型：
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作者：
W. May
首先，我想说的是宗教情感，我发现它有助于描述医护人员对临终病人的关怀，尤其是对晚期痴呆症患者的关怀。这个词就是约。这是一个圣经术语；但如今，它涵盖了房地产契约等可疑的手段。房地产契约的作用往往低于合同的道德水平，将一些人赶出社区。然而，从传统意义上讲，“契约”这个词比“合同”这个概念更有助于探究医生对病人的义务。我所说的这种契约和契约似乎是近亲；它们都包括双方之间的协议和交换。但是，在精神上，契约和契约明显不同。契约是外在的；契约是有关各方的内部契约。我们签订合同是为了方便履行合同。合同是有限的和有时间限制的——无论是修理管道的合同，还是为医疗程序收取费用的合同。
A word, first, about the religious sensibility that I have found helpful to describe the care professionals owe to dying patients, particularly patients with advanced dementia. That word is covenant. It is a biblical term; but, today, it covers such dubious devices as real estate covenants. A real estate covenant often operates below the moral level of a contract to wall some people out of a neighborhood. Classically understood, however, the word covenant helps probe the obligations of doctors to their patients more deeply than the notion of a contract. Covenants of the sort I have in mind and contracts appear to be first cousins; they both include an agreement and an exchange between parties. But, in spirit, contracts and covenants differ markedly. Contracts are external; covenants are internal to the parties involved. We sign contracts in order to discharge them expediently. Contracts are limited and time-bound — whether a contract to fix plumbing or to charge such and such for a medical procedure.