Today´s medical self and the other: Challenges and evolving solutions for enhanced humanization and quality of care

PLoS One. 2017 Jul 31;12(7):e0181514. doi: 10.1371/journal.pone.0181514. eCollection 2017.

Abstract

Background: Recent scientific developments, along with growing awareness of cultural and social diversity, have led to a continuously growing range of available treatment options; however, such developments occasionally lead to an undesirable imbalance between science, technology and humanism in clinical practice. This study explores the understanding and practice of values and value clusters in real-life clinical settings, as well as their role in the humanization of medicine and its institutions. The research focuses on the values of clinical practice as a means of finding ways to enhance the pairing of Evidence-Based Medicine (EBM) with Values-based Medicine (VBM) in daily practice.

Methods and findings: The views and representations of clinical practice in 15 pre-CME and 15 post-CME interviews were obtained from a random sampling of active healthcare professionals. These views were then identified and qualitatively analyzed using a three-step hermeneutical approach. A clinical values space was identified in which ethical and epistemic values emerge, grow and develop within the biomedical, ethical, and socio-economic dimensions of everyday health care. Three main values-as well as the dynamic clusters and networks that they tend to form-were recognized: healthcare personnel-patient relationships, empathy, and respect. An examination of the interviews suggested that an adequate conceptualization of values leads to the formation of a wider axiological system. The role of clinician-as-consociate emerged as an ideal for achieving medical excellence.

Conclusions: By showing the intricate clusters and networks into which values are interwoven, our analysis suggests methods for fine-tuning educational interventions so they can lead to demonstrable changes in attitudes and practices.

MeSH terms

  • Attitude of Health Personnel*
  • Ethics, Medical
  • Evidence-Based Medicine*
  • Health Personnel*
  • Health Services Research
  • Humans
  • Mexico
  • Morals
  • Physician-Patient Relations
  • Quality of Health Care*
  • Social Class

Grants and funding

Funding for this study was provided by Mexico's Council of Science and Technology (CONACYT) 068673 and the General Direction of Academic Personnel Affairs of UNAM (DGAPA) for the Papiit project, ID 400112, as well as the SIP Multidisciplinary Project 1715 in its 20160506 and 20171489 module at the Instituto Politécnico Nacional.