从口述历史呈现乳房外科医师的专业涵养  

Illustrating Professional Conservations of Breast Surgeons with Oral History

作　　者：陈妤嘉 蔡笃坚 CEHN Yujia;CAI Dujian(Social Empowerment Alliance,Taipei 10455,China;Center for Bioethics and Social Medicine,Pingtung Christian Hospital,Pingtung 90059,China;Beijing Oriental Life Culture Research Institute,Beijing 102209,China)

机构地区：[1]台湾社会改造协会,台湾台北10455 [2]屏东基督教医院生命伦理暨社会医学中心,台湾屏东90059 [3]北京东方生命文化研究所,北京102209

出　　处：《中国医学伦理学》2019年第11期1470-1476,共7页Chinese Medical Ethics

摘　　要：在中国台湾地区乳房医学会发展的脉络下,以口述历史方式采访主要管理者,透过Jonsen等提出的四主题临床伦理决策分析,呈现乳房外科医师的专业特质。发现技术和观念的精进,带动多专科照护团队和乳房中心的制度形成,以及致力于学习的精神开创了医疗适应性的变革。医患之间互相信赖、分享、支持,乃至于共同决策,落实了患者偏好的保障。重视患者的生活质量,开创了发展家属、医者和患者伙伴关系的志业。而以医学会的力量保障健保给付,协助公平的资源分配,甚而照护弱势群体,克服了情境特征的限制而带动追求公义社会的量能。通过口述历史访谈,呈现乳腺癌治疗专业与患者共苦,从而开展出全新的医学职业精神。Under the context and development of Breast Cancer Society of Taiwan(BCST),the main leaders were interviewed by oral history,and the four themes proposed by Jonsen and others were used for clinical ethical decision-making analysis to present the professional characteristics of breast surgeons.It is found that the improvement of technology and concept has led to the formation of multispecialty care team and breast center system.Meanwhile,it is also found that the spirit of dedicated learning has created the change of medical adaptability.Mutual trust,sharing and support between doctors and patients,even with sharing decision making,could implement the guarantee of patients’preferences.Emphasizing the life quality of patients has created professional vocations to establish partnership among families,patients and doctors.The efforts of BCST to ensure the national insurance payments,to support resources fair allocation,to take care of the disadvantaged and to overcome limitations in contextual features have created momentums to just society.Through oral history interviews,the paper has shown that the breast cancer treatment profession and patients suffer together,so as to develop a new medical professionalism.

关 键 词：乳房医学会 制度改革 共同决策 伙伴关系 医学职业精神 

分 类 号：R197.32[医药卫生—卫生事业管理]