의료에서 의사의 실천적 지혜(phronesis)
Published Online: Jun 30, 2006
ABSTRACT
All doctors confront ethical dilemmas in the course of medical practice. The principles of medical ethics can assist doctors in making practical decisions when confronted with such dilemmas. The current medical field is subject to a scientific paradigm which sees medicine as a simple composition of scientific knowledge and techniques. Medicine under this scientific paradigm has a tendency to apply objective standards and scientific methods to all problems. From this point of view, specific experiences of individual patients are easily overlooked. However, it is also true that the personal life of each patient is an important part of medical practice along with the objective medical knowledge of doctors. Thus, the current scientific paradigm, which is too rigid to sufficiently cover these two distinct characteristics, is in need of modification.
A more practical paradigm would recognize the positive medical relationship between doctors and patients and would pursue the realization of the good of patients. Under such a paradigm, doctors would strive to reach decisions on medical treatment that serve the patient's best interests. In this respect, phronesis can be utilized to establish such a practical paradigm. Phronesis is an ethical insight, an ability to discern, in a given set of circumstances, what moral choice or course of action is most conducive bringing about the good of the individual patient. Phronesis leads doctors to make the right decision for each patient and to adopt the appropriate values and actions in various situations. A doctor trained to have phronesis will make the best decision for patients who are in extreme pain. Therefore, phronesis may be useful as a practical principle of medical practice applicable to various problems that cannot be solved only with the objective principles of the scientific paradigm.