The founding of the Centre for Palliative Medicine, Medical Ethics and Communication Skills: a new step toward the development of patient-oriented medicine in Croatia.

摘要

PATIENT-ORIENTED MEDICINE One of the main conceptual changes in the 20th century medicine is the inclusion of social dimension. The "golden era" of Parson's medical model (1), which uses the "active-passive" dichotomy to describe the positions and expectations of physicians and patients, is over. Physicians' supremacy has slowly and systematically been challenged by the emergence of third party stakeholders, development of new media sources, strengthening of the civil society, and democratization of information, which all have contributed to the development of the patients'active role in the healing processes (2). The rise of medical consumerism has stimulated the medical authorities to react with a new ideological policy: the patient-oriented medicine, insisting on the partnership in the diagnostic and therapeutic processes, and viewing the patient as a person with biological, psychological, social, and spiritual needs (2). This goal has been developing in the Western societies for years, while it is still insufficiently recognized in Croatia. There are several indicators of this problem in Croatia: the insufficient and unsystematic institutional approach to palliative medicine, weak non-governmental organization network, mis-recognition of the importance of communication processes in everyday physicians' practice, insufficient education beyond the mechanistic approach to disease, and inadequate legislative practice dealing with patients'rights.