Bedside Manners: The Foundational Concepts, Values, and Assumptions Underlying the Practice of Medicine
摘要
In this chapter, we explore the wisdom of physicians whose work has shaped our understanding of the power of bedside manner—and why a doctor’s behavior at the patient’s side is essential to quality care. We begin with Hippocrates and the enduring significance of the Hippocratic Oath as a foundation for medical ethics. we look at John Gregory’s groundbreaking lectures, Observations on the Duties and Offices of the Physician and on the Method of Prosecuting Enquiries in Philosophy, which pioneered efforts to strengthen the doctor–patient relationship. Gregory advocated for a bedside manner characterized by gentleness, sympathy, and compassion, believing that sympathy helped gain the patient’s trust and could be crucial for their recovery. He thought that humanity—the sensibility of the heart to feel for the distress of others—was the most important trait a physician could possess. This approach required doctors not only to be intellectually vigorous but also to maintain honesty, acknowledge and rectify mistakes, and prioritize patient welfare above commercial motives or status pursuits His student, Thomas Percival, built on this work with Medical Ethics, a set of guidelines that influenced physician conduct for decades and became the basis for the first American Medical Association Code of Ethics. Percival’s code established clear principles of beneficence and patient autonomy, advocating for physicians to prioritize the patient’s welfare, respect patient choice, and ensure equitable treatment—even for the poor and mentally impaired. He emphasized virtues such as tenderness, steadiness, and humanity, and placed strong importance on hope, comfort, and confidentiality in physician-patient relationship. Percival’s ethics move beyond the Hippocratic tradition by focusing on the moral authority and independence of physicians in service to society and emphasizing professional responsibility to care for the sick.