PHIL 226, Week 4

Announcements

Exam 1, Thursday, Oct. 4.

Guest lectures:

• Oct. 18, Steve Abdool, St. Michael's Hospital, Toronto: "Confidentiality and the Duty to Disclose".
• Nov. 6, Jill Oliver, William Osler Health System, Bramption: "Sex, Conceptual Change, and Ethics: How Changing What We Think Might Change What We Think We Should Do".

Professional-Patient Relationships

Why Metaphors Matter to Thought and Action

Metaphors are not just literary flourishes, but can strongly affect how we think about things. For example, compare the following: Marriage is an institution. Marriage is a trap. Marriage is a partnership.

Metaphors are often based on complex underlying analogies, which involve systematic mappings between different domains. See "The Analogical Mind."

Metaphors are often laden with emotion, and so can affect actions and decisions. See the marriage example.

What metaphors best describes the relationship between the state and patients? Is the state the nurturing parent, strict parent, servant,or nanny?

Metaphors and Models of Doctor-Patient Relationships

Doctor/patient is like which of the following?

• Parent/child.
• Partner/partner
• Technician/client
• Rational contractors
• Producer/consumer
• Friends
• Multiple relationships

Ethical implications of these metaphors

• Which way of thinking has the best consequences?
• Which way of thinking fits best with rights and duties?
• Which way of thinking fits best with ethical principles?

Other issues

• Are doctors intimates or strangers?
• How should doctor/patient negotiations operate?
• Are patients clients? Are patients customers?
• Metaphors and politics.

Metaphors for Nurse/Patient Relationships

Nurse/patient is like which of the following?

• Parent (mother)/child
• Technician/client
• Boss/servant
• Advocate/client
• Doctor surrogate/patient
• Friends
• Multiple relationships

Ethical implications of these metaphors

• Which way of thinking has the best consequences?
• Which way of thinking fits best with rights and duties?
• Which way of thinking fits best with ethical principles?

Review Questions for Week 4

1. How do metaphors affect how we think about health care?
2. What are the most prevalent metaphors for describing the relationship between doctors and patients? Which of these are ethically preferable?
3. What are the most prevalent metaphors for describing the relationship between nurses and patients? Which of these are ethically preferable?
4. Short essay topic: Use the consequences, rights/duties, and principles reasoning patterns to evaluate what would be the best metaphors to describe the ideal relationship between health care professionals and their patients or clients.

Phil 226

Computational Epistemology Laboratory.

Paul Thagard

This page updated Oct. 1, 2012