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Power in the physician-patient relationship

Thesis (M.A.)--University of Stellenbosch, 2000.

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Main Author: Broekmann, Reginald J. (Reginald John)
Other Authors: Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Philosophy.
Format: Thesis
Language:en_ZA
Published: Stellenbosch : Stellenbosch University 2012
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access_status_str Open Access
author Broekmann, Reginald J. (Reginald John)
author2 Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Philosophy.
author_browse Broekmann, Reginald J. (Reginald John)
Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Philosophy.
author_facet Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Philosophy.
Broekmann, Reginald J. (Reginald John)
author_sort Broekmann, Reginald J. (Reginald John)
collection Thesis
dc_rights_str_mv Stellenbosch University
description Thesis (M.A.)--University of Stellenbosch, 2000.
format Thesis
id oai:scholar.sun.ac.za:10019.1/51884
institution Stellenbosch University (South Africa)
language en_ZA
last_indexed 2026-06-10T12:43:47.401Z
license_str Other — see source repository
provenance_str_mv Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository
publishDate 2012
publishDateRange 2012
publishDateSort 2012
publisher Stellenbosch : Stellenbosch University
publisherStr Stellenbosch : Stellenbosch University
record_format dspace
source_str SUNScholar — Stellenbosch University Repository
spelling oai:scholar.sun.ac.za:10019.1/51884 Power in the physician-patient relationship Broekmann, Reginald J. (Reginald John) Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Philosophy. Physician and patient Medical ethics Power (Philosophy) Dissertations -- Applied ethics Theses -- Applied ethics Thesis (M.A.)--University of Stellenbosch, 2000. ENGLISH ABSTRACT: This paper examines aspects of power within the physicianpatient relationship. The historical development of the physician-patient relationship is briefly reviewed and some of the complexities of the relationship highlighted. It is shown that, historically, there is no imperative for the physician to consider only the interests of the patient and it has always been acceptable to consider the interests of a third party, such as the State or an employer - essentially the interests of whoever is paying the physician. The classical sources of power are then considered. These sources include legitimate power, coercive power, information power, reward power, expert power, referent power, economic power, indirect power, associative power, group power, resource power and gender power. Other approaches to power are also considered such as principle-centred power as described by Covey, power relationships as explained by Foucault, the power experience as described by McClelland and an analysis of power as expounded by Morriss. The various sources of power are then considered specifically within the physician-patient relationship to determine: if this particular type of power is operative in the physicianpatient relationship, and if so if it operates primarily to the advantage of the physician or the advantage of the patient. A simple method of quantifying power is proposed. Each form of power operative in the physician-patient relationship is then considered and graphically depicted in the form of a bar chart. Each form of power is shown as a bar and bars are added to the chart to 'build up' an argument which demonstrates the extent of the power disparity between physician and patient. It is clearly demonstrated that all forms of power operate to the advantage of the physician and in those rare circumstances where the patient is able to mobilize power to his/her advantage, the physician quickly calls on other sources of power to re-establish the usual, comfortable, power distance. Forms of abuse of power are mentioned. Finally, the ethical consequences of the power disparity are briefly considered. Concern is expressed that the power disparity exists at all but this is offset by the apparent need for society to empower physicians. Conversely, consideration is given to various societal developments which are intended to disempower physicians, particularly at the level of the general practitioner. Various suggestions are made as to how the power relationships will develop in future with or without conscious effort by the profession to change the relationship. AFRIKAANSE OPSOMMING: Hierdie voordrag ondersoek aspekte van mag in die verwantskap tussen pasiënt en geneesheer. Die historiese ontwikkeling van die verwantskap word kortliks hersien en 'n kort beskrywing van die ingewikkeldheid van die verwantskap word uitgelig. Vanuit 'n historiese oogpunt, word 'n geneesheer nie verplig om alleenlik na die belange van die pasiënt om te sien nie en was dit nog altyd aanvaarbaar om die belange van 'n derde party soos die Staat of 'n werkgewer se belange to oorweeg - hoofsaaklik die belange van wie ookal die geneesheer moet betaal. Die tradisionele bronne van mag word oorweeg. Hierdie bronne sluit in: wetlike mag of 'gesag', die mag om te kan dwing, inligtingsmag, vergoedingsmag, deskundigheidsmag, verwysingsmag, ekonomiesemag, indirektemag, vereeningingsmag, groepsmag, bronnemag en gelslagsmag. Alternatiewe benaderings word ook voorgelê, naamlik die beginsel van etiese mag soos deur Covey beskryf, krag in menslike verhoudings soos deur Foucault, die ondervinding van krag soos beskryf deur McClelland en 'n ontleding van krag soos deur Morriss verduidelik. Hierdie verskillende mag/gesagsbronne word spesifiek met betrekking tot die geneesheer-pasiënt verhouding uiteengesit om te besluit: of hierdie tipe mag aktief is tussen geneesheer en pasiënt, en indien wel, werk dit tot die voordeel van die geneesheer of die pasiënt. 'n Eenvoudige sisteem vir die meting van mag/gesag word voorgestel. Die bronne word individueeloorweeg en gemeet en die resultaat in 'n grafiese voorstelling voorgelê op so 'n wyse dat 'n argument daardeur 'opgebou' word om die verskille van van mag/gesag tussen geneesheer en pasiënt uit te wys. Dit word duidelik uiteengesit dat alle vorms van mag/gesag ten gunste van die geneesheer werk. Kommer is getoon dat hierdie magsverskil werklik bestaan, asook die snaakse teenstelling dat die gemeenskap wil eintlik die geneesheer in "n magsposiesie plaas. Die etiese gevolge van hierdie ongebalanseerde verwantskap, asook die moontlikheid van wangebruik van hierdie mag word ook genoem. Verskillende gemeenskaplike ontwikkelinge wat die mag van die geneesheer wil wegneem word geidentifiseer, meestalop die vlak van die algmene praktisyn. Verskeie voorstelle vir toekomstige ontwikkeling van die verwantskap word voorgelê, met of sonder spesifieke pogings van die professie om die verwantskap te verbeter. Master 2012-08-27T11:34:44Z 2012-08-27T11:34:44Z 2000-04 Thesis http://hdl.handle.net/10019.1/51884 en_ZA Stellenbosch University 88 p. : ill. application/pdf Stellenbosch : Stellenbosch University
spellingShingle Physician and patient
Medical ethics
Power (Philosophy)
Dissertations -- Applied ethics
Theses -- Applied ethics
Broekmann, Reginald J. (Reginald John)
Power in the physician-patient relationship
title Power in the physician-patient relationship
title_full Power in the physician-patient relationship
title_fullStr Power in the physician-patient relationship
title_full_unstemmed Power in the physician-patient relationship
title_short Power in the physician-patient relationship
title_sort power in the physician patient relationship
topic Physician and patient
Medical ethics
Power (Philosophy)
Dissertations -- Applied ethics
Theses -- Applied ethics
url http://hdl.handle.net/10019.1/51884
work_keys_str_mv AT broekmannreginaldjreginaldjohn powerinthephysicianpatientrelationship