臨床現場における医師の「自己決定」

概要

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This paper examines what is the doctor’s self-determination in the context of decision-making over patients’ treatment policies. The word “self-determination” means deciding something for oneself, by oneself. “Decision-making” denotes adopting a course of action from multiple alternatives. “Self-determination” is often used to mean the right to self-determination of vulnerable groups such as patients. However, this paper considers the implications and rights of the self-determination by physicians which is commonly regarded as one form of decision-making. This type of professional self-determination often significantly influences others (i.e. patients). A desired decision-making by physicians is based on the selection of principles. And that selection is based on the personal beliefs. Finding one set of beliefs is not the final goal of this paper. With a reflective and critical perspective, repeated examinations of beliefs are needed in order to examine the validity and reliability of the selected beliefs, to improve them, and to determine their application in the medical decision-making. Finally, the reconstruction of medical educational system (in Japan) for the reflective and critical thinking is truly needed to conquer “akrasia (moral weakness)”.