Thesis (M.A.)--University of Stellenbosch, 2000. / 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. / AFRIKAANSE OPSOMMING: Hierdie voordrag ondersoek aspekte van mag in die
verwantskap tussen pasiënt en geneesheer. Die historiese
ontwikkeling van die verwantskap word kortliks hersien en 'n
kort beskrywing van die ingewikkeldheid van die verwantskap
word uitgelig.
Vanuit 'n historiese oogpunt, word 'n geneesheer nie verplig
om alleenlik na die belange van die pasiënt om te sien nie en
was dit nog altyd aanvaarbaar om die belange van 'n derde
party soos die Staat of 'n werkgewer se belange to oorweeg -
hoofsaaklik die belange van wie ookal die geneesheer moet
betaal.
Die tradisionele bronne van mag word oorweeg. Hierdie
bronne sluit in: wetlike mag of 'gesag', die mag om te kan
dwing, inligtingsmag, vergoedingsmag, deskundigheidsmag,
verwysingsmag, ekonomiesemag, indirektemag,
vereeningingsmag, groepsmag, bronnemag en gelslagsmag.
Alternatiewe benaderings word ook voorgelê, naamlik die
beginsel van etiese mag soos deur Covey beskryf, krag in
menslike verhoudings soos deur Foucault, die ondervinding
van krag soos beskryf deur McClelland en 'n ontleding van krag
soos deur Morriss verduidelik.
Hierdie verskillende mag/gesagsbronne word spesifiek met
betrekking tot die geneesheer-pasiënt verhouding uiteengesit
om te besluit:
of hierdie tipe mag aktief is tussen geneesheer en pasiënt, en
indien wel, werk dit tot die voordeel van die geneesheer of die
pasiënt.
'n Eenvoudige sisteem vir die meting van mag/gesag word
voorgestel. Die bronne word individueeloorweeg en gemeet
en die resultaat in 'n grafiese voorstelling voorgelê op so 'n
wyse dat 'n argument daardeur 'opgebou' word om die verskille
van van mag/gesag tussen geneesheer en pasiënt uit te wys.
Dit word duidelik uiteengesit dat alle vorms van mag/gesag ten
gunste van die geneesheer werk. Kommer is getoon dat
hierdie magsverskil werklik bestaan, asook die snaakse teenstelling dat die gemeenskap wil eintlik die geneesheer in
"n magsposiesie plaas.
Die etiese gevolge van hierdie ongebalanseerde verwantskap,
asook die moontlikheid van wangebruik van hierdie mag word
ook genoem.
Verskillende gemeenskaplike ontwikkelinge wat die mag van
die geneesheer wil wegneem word geidentifiseer, meestalop
die vlak van die algmene praktisyn.
Verskeie voorstelle vir toekomstige ontwikkeling van die
verwantskap word voorgelê, met of sonder spesifieke pogings
van die professie om die verwantskap te verbeter.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/51884 |
| Date | 04 1900 |
| Creators | Broekmann, Reginald J. (Reginald John) |
| Contributors | Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Philosophy. |
| Publisher | Stellenbosch : Stellenbosch University |
| Source Sets | South African National ETD Portal |
| Language | en_ZA |
| Detected Language | English |
| Type | Thesis |
| Format | 88 p. : ill. |
| Rights | Stellenbosch University |
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