Akademik Veri Yönetim Sistemi
Turkiye Klinikleri Journal of Medical Sciences, cilt.30, sa.4 SUPPL., 2010 (SCI-Expanded)
Disease is the pathoanatomical or pathophysiological entity that manifests itself in symptoms that the patient experiences and the doctor discover. In this context diseases are abstractions that have no concrete existence except as portrayed in particular patients. Illness is the patient's experience of the effects of the disease process; it includes not only the symptoms but the interpretations and meanings of the symptoms, as well. In this context, illness is the total subjective perceptions which result in changes in a person's feelings and behaviors. The magnitude of these changes, relate to how one perceives own physical and mental symptoms rather than the biological changes themselves. The essence of the art of medicine is based on the ability to apply general medical knowledge and experience to the patient as is a specific biopsychosocial entity. If we consider the limitation of the general medical knowledge and experiences versus the virtualy limitless biopsychosocial characteristics of the patient, implementing the medical knowledge to an individual expressing illness, inevitably ends in a mismatch. In this regard, the decision of malingering in a patient by focusing on the general scheme of medical information and experience and assessing the ill patient as such without focusing on the patient expressing illness himself might result in a questionable ethical situation. In his approach to the patient, the fear that the physician will be deceived by the same patient expressing illness himself will cause a potential ethical conflict against the role of the physician. The expression of illness addressed to a physician, regardless of the underlying cause, could be a cry for help aiming to get some attention to psychological and psychiatric problems of the patient or could quite possibly be a reflection of the deeper emotions which compel the person to be in need of being a patient. The prejudice of malingering against a patient would almost inevitably hinder the job of the physician in trying to understand the reasons behind the expressing of the illness by the patient given the complex biopsychosocial entity of the patient. For this reason, this article is based on the hypothesis that it is ethically difficult to decide on malingering of a patient per medical ethics. © 2010 by Türkiye Klinikleri.