interventions, but leaves the choice up to the patient. The Deliberative Model: the physician educates and engages the autonomous patient in dialogue about their ailments, as well as the medical interventions available. The values of both the patient and the doctor are ‘in play’: they both participate in the decision-making process concerning the best treatment options. The Paternalistic Model: the physician knows what the patient needs (and/or finds out) and then directs the patient to undergo a specific treatment. The doctor has nearly all of the responsibility to analyze the problem and to consider alternative treatments. The Instrumental Model: the physician treats the patient as a means to an end, as in medical experimentation, drug trials, etc… without the patient’s informed consent. While many of these models have their place in biomedicine (save perhaps for the Instrumental Model), the ideal Physician-Patient relationship that is to be preferred as the most ‘caring’ is the Deliberative Model ; some exceptions being when a patient unconscious it is the doctor who must decide the treatment alone, and/or a child is treated alone. In his article, Faber adds yet two more models to the list: The Contractual Model (as in a surgeon or specialist who has been contracted to perform a specific procedure on a patient—the trust is based in the bindingness of the contract), and The Affinity Model (as in a doctor who is affiliated with the patient through friendship, family connection, and/or through being a member of a specific ethnic or religious community: the trust has part of its basis in this affiliation).
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- Fall '16
- Physician, Carol Gilligan, Nel Noddings