In this paper I briefly summarize Pellegrino’s phenomenological analysis of the ethics of the physician–patient relationship. In delineating the essential elements of the healing relationship (the fact of illness, the profession of healing, and the act of medicine), Pellegrino demonstrates the necessity for health care professionals to understand the patient’s lived experience of illness. In considering the phenomenon of illness, I identify certain essential characteristics of illness-as-lived that provide a basis for developing a rigorous understanding of the patient’s experience. I note recent developments in the systematic delivery of health care that make it difficult for health care professionals to realize Pellegrino’s ethical model of the role of healer. Such developments limit both the physician’s freedom to act on behalf of the patient without the constraint of third parties and the physician’s freedom to act in light of his or her own ethical or religious convictions. Given these difficulties, I note MacIntyre’s call for the development of moral communities, as an alternative to the prevailing culture, and share a first-hand example illustrating how intentional Christian community provides an alternative nurturing context that permits the full development of the healing relationship.

中文翻译：

---

愈合关系：埃德蒙·佩莱格里诺（Edmund Pellegrino）医患相遇的哲学。

在本文中，我简要概述了佩莱格里诺对医患关系伦理的现象学分析。在描述治疗关系的基本要素（疾病的事实，治疗的专业和医学行为）时，佩莱格里诺（Pellegrino）证明了医疗保健专业人员有必要了解患者的生病经历。在考虑疾病现象时，我确定了疾病生存的某些基本特征，这些特征为发展对患者经验的严格理解提供了基础。我注意到医疗保健系统化提供方面的最新发展，这使医疗保健专业人员难以实现佩莱格里诺关于治疗者角色的道德模型。这种发展既限制了医师在不受第三方约束的情况下代表患者采取行动的自由，又限制了医师根据其自身的道德或宗教信仰采取行动的自由。考虑到这些困难，我注意到麦金太尔呼吁发展道德共同体，以取代普遍的文化，并分享一个第一手的例子，说明故意的基督教共同体如何提供替代性的养育背景，从而使康复关系得到全面发展。