DIALOGUE MEDICINE - A HEALTH-LIBERATING ATTITUDE IN GENERAL-PRACTICE

Dialogue medicine is presented as the prime means of understanding pat ients' illnesses. It is a practical attitude especially aimed to assis t or inspire patients to consider, see and manage their illness-demand ing efforts to unwittingly suppress or disguise such self-reproaching thoughts as are worse to bear than the feeling of being afflicted with a disease. Along with diagnosing patients' perceived bodily disorders , doctors can choose to see them as persons whose ailments stand for e fforts to manage their existence as communicative human beings. The co re of the paper is an encounter between the author and a female patien t which illuminates the usefulness of genuine dialogue in medical prac tice. The paper illustrates how the dialogical attitude helps patients to see and manage their difficult life-situations and how the doctor can be inspired to change and develop and improve his/her skills as a dialogue partner. Doctors' dialogical attitude in the encounter encomp asses for example openness, empathy, sensitivity, courage, attentivene ss and responsiveness, accompanied by concern, trust, respect, affecti on, appreciation and hope. The philosophical and theoretical foundatio ns of the concept of dialogue medicine are sketched out and some pract ically significant traits are described. (C) 1998 Elsevier Science Ire land Ltd.