临床判断:基于病人的真实世界

Clinical Judgment:Based on the Real World of Patients

理化检查报告提供的情况远非病人的全部真实;病史展示的病人的医学世界和生活世界对于疾病的鉴别与诊断的价值永远都不过时;诊疗个体化包括双重内涵;病人的身体感受远比某些生理指标变化的意义更重要;医生进入病人的真实世界,包括病人的情感世界,只有通过医患间的对话与交流才能彼此感知,医生与病人两个主体的融合在于两者的主体间性;医生的价值取向和使命感,是医生进入病人的疾病世界、生活世界和情感世界的关键。

The reports of physical exarmnation and laboratory test are far from revealing all the truth of the patients. The medical world and living world of patients shown through the patients＇ medical history never lose the value for identification and diagnosis of the disease. There are two meanings of personalized medicine. Firstly, it is more meaningful of body feelings than the results of physical examinations and laboratory tests. Secondly, the doctors should go into the living world of the pauents, including their emotional world, in which the doctors and the patients can feel each other through interaction and communication. The integration of the doctors and patients lies in the inter-subjectivity of them. The values and the sense of responsibility of the doctors are critical for doctors to go into the medical world,the living world and the emotional world of the patients.