Ethical Dilemma Doctor-Patient Relation

Unit Ten: Oncology

Vocabulary Hepatitis [hɛpəˈtaɪtɪs] (n.) A medical condition defined by the inflammation of the liver and characterized by the presence of inflammatory cells in the tissue of the organ. Carcinogen [kɑrˋsɪnədʒən] (n.) Any substance or agent that tends to produce a cancer.

Vocabulary Prophylactic [͵profəˋlæktɪk] (adj.) A medication or a treatment designed and used to prevent a disease from occurring. Palliative [ˋpælɪ͵etɪv] (adj.) Relieving or soothing the symptoms of a disease or disorder without effecting a cure.

Vocabulary Metastasis [məˋtæstəsɪs] (n.) The spreading of a disease, esp cancer cells, from one part of the body to another. Anemia [əˋnimɪə] (n.) A deficiency in the oxygen-carrying component of the blood.

The analysis and treatment of tumors Tumor -multiply -invade surrounding tissues -affect function Cancer is the leading cause of human death (WHO) Oncology

Causes of cancer Biologically virus, bacteria, parasitic infection Physically insufficient intake of fruit & vegetable heavy smoker or drinker environmental pollution aging

Prevention 30% of cancers cases are preventable Early screening Education -avoid alcohol & cigarette -balanced diet -regular daily routine -exercise

Oncology care Treatment -radiotherapy(elimination & control) -chemotherapy Palliative care -give supportive drugs only -to ease uncomfort from treatments -to ease psychosocial distress from both patients and their family

Discussion-1 What could cause cancer?

Discussion-2 How can we prevent cancer?

Discussion-3 If you are diagnosed with terminal cancer, what will you do? Take the treatment? Or make your bucket list?

Discussion-4 Do physicians have the right to give up on terminal patients?

Supplementary Reading: Out of Camelot, Knights in White Coasts Lose Way

Vocabulary Medicare It is a kind of Federal health insurance program that pays for medical care for people over 65 and certain disabled Americans. People only have to pay the fee annually and they can have unlimited health care.

Vocabulary Managed care: It is supposed to save American medicine by stopping the rise of spending in health care. People are asked to pay additional fee if it is necessary to undergo extra medical procedure.

Vocabulary Paternalistic [pətɝnl`ɪstɪk] (adj.) Treating or governing people in a fatherly manner. Usher [ˋʌʃɚ] (v.) To lead or conduct. Stem [stɛm] (v.) To stop or hold back.

Vocabulary Knave [nev] (n.) A false, deceitful fellow; a dishonest person; one given to fraudulent tricks or practices. Bilk [bɪlk] (v.) To defraud, cheat, or swindle. Chasm [ˋkæzəm] (n.) A pronounced difference of opinion or interests.

Vocabulary Sap [sæp] (v.) To gradually weaken. Wane [wen] (v.) To decline; fail; sink; approach an end.

Main idea Doctors have lost their special status in the last four decades since Medicare has been introduced.

Main concern Doctors nowadays complain about their status quo. Who is to blame for this situation?

Free-for-all Abandonment of ideals. doctor’s income has skyrocketed since Medicare was introduced in ’s→$50, ’s→$250,000 Health Maintenance Organization(HMO) (1973~) & managed care are introduced to cut down the cost from Medicare.

Knight or Knave Conception discussed by Dr. Sachin H. Jain and Dr. Christine K. Cassel. Knight: practice medicine to save and improve lives. Physician Knave: put financial well-being before patients.

Doctor-Patient relation Discontentment from the doctors have widen the chasm. -time constraint -malpractice fear -decreasing income Statistic: %(2600 samples) have lost their enthusiasm for medicine, and 87% of them said the overall morale had declined during that time. 75% said medicine is no longer rewarding.

Conclusion Doctors should stick to their core professional and never put financial well-being before their patients.

Discussion-1 What does the sociologist Paul Starr meant by “the 20 th century medicine was the heroic exception that sustained the waning tradition of independent professionalism”?

Discussion-2 We can see through the article that US doctors are not content with Medicare and managed care, but what about our National Health Insurance? Is there any problem with this medical policy?

Discussion-3 “Knight” and “Knave”, which one do you want to be in the future?

Thank you for your attention!