权力、信任和风险：关于权力问题缺失的一些反思

Power, Trust, and Risk: Some Reflections on an Absent Issue

在医护人员中间进行的现代讨论中,有一种奇怪的现象是,缺乏对权力的讨论。就关于适当的医患关系的讨论和关于信任的讨论而言,这很显然是事实。这种缺乏造成了一些后果。因为在医疗保健体制中,权力问题的缺失妨碍了关于重要的制度形式的认真公开的道德讨论。此外,关于如何使医生与患者进行互动的一些提议,是相当不切实际的,这主要也是因为忽视了权力问题。

In modern discussions among health professionals there is a strange lack of discussions of power. This is most notably true for the discussions about proper physician-patient relations and the discussions about trust. This article explores some of the consequences of this absence. It is argued that the absence of the issue of power hampers a serious and open moral discussion of important institutional forms in the health care system. It is also argued that some of the proposals for how to organize physician-patient interaction are rather unrealistic, mainly because the issue of power is neglected. Finally, the article develops some ideas about how power ought to be approached in modern health care.