临床共情与叙事能力:将《塔木德》当作文学作品阅读的意义

摘要

临床环境中的“治疗潜力”主要依赖于医患之间建立和维持的共情关系.共情关系能让医护人员充分考虑患者的最大利益,并据此做出临床判断和决定,实现“叙事能力”.临床医师分享“文学作品的文本细读心得”,并探讨“临床反思性写作”的“叙事医学”模式是培养共情能力的必要途径.近期的实验研究证实这种以文学作品阅读为基础的培养模式在学术界和临床领域都已受到充分肯定.作为一个文学作品,《塔木德》的价值一直被低估.事实上,作为文学作品的源头,它们对“叙事能力”的实现意义重大.通过实践过程中对生命伦理原则的关注,制约叙事医学的局限性已被打破.%The "curative potential" in almost any clinical setting depends on a caregiver establishing and maintaining an empathic connection with patients so as to achieve "narrative competence" in discerning and acting in accord with their best interests.The "narrative medicine" model of shared "close reading of literature and reflective writing" as a means of fostering a capacity for clinical empathy has gained validation with recent empirical studies.Talmudic legends,like that of Rabbi Judah's death,are under-appreciated,relevant sources of literary fiction for these efforts.The limitations of narrative medicine are readily counterbalanced by simultaneously practiced attention to traditional bioethical principles.