Читать книгу Medical Communication: From Theoretical Model To Practical Exploration - Tao Wang - Страница 20

The public participation model requires that the public participate in the discussion of scientific and technological issues in a democratic system to ensure the democratization and openness of public policy decision-making, at the same time, to improve the public’s scientific literacy in the process of participating in the discussion, and to ensure the public’s understanding of science, technology, and research. In the process of participation, the public will be aware of the relationship between science and society. This model emphasizes that the public should take the initiative to participate in the setting up of the scientific agenda, and engage in dialogue with the scientific community, so as to establish a democratic mechanism for public participation in scientific decision-making. So this model is also called the democratic model or the dialogue model. Durant, who proposed the deficit model, also saw the limitations of the deficit model in his later period. He believed that the missing model and the democratic model could coexist as two models of public understanding of science.

Since the second half of the 20th century, the development of science and technology has not only improved human life, but also brought anxiety and fear to the public. The development and application of nuclear energy, genetically modified food, cloning technology, and many other frontier technologies have caused widespread social controversy. Health and safety risks and ethical challenges associated with these technologies have created a crisis of public trust in science. Therefore, the government and scientists are gradually aware of the importance of developing scientific dialogue. The public participation model, which emphasizes the two-way dialogue between experts and non-experts, is widely considered to be superior to the deficit model. In brief, the deficit model is more likely to be suitable in some areas, such as formal science education, while the democratic model or public participation model is more suitable in other areas, such as public debate on environmental issues relative to genetically modified foods.

Shall we imagine applying the public participation model to medical communication? For example, a patient was found to have early gastric cancer and needed treatment. Doctors talk with patients and their families, communicating and informing them that there are several treatment options available, the advantages of each treatment, which complications are likely to occur, the current situation of patients, and which treatment is more appropriate. In the process of communicating and discussing with family members, the two sides finally reached an agreement to choose the most suitable treatment for patients. This is the model of public participation in medical communication. Facing the same patient, if the doctor simply tells the patient and his family that they must choose a treatment method without any communication and discussion, then that is the deficit model in medical communication. In this scenario, we can see that the model of public participation in medical communication may be more easily understood and adopted by the public. However, in the public participation model, it is also necessary to take into account the degree of public participation, the basic cultural level of the public and the acceptability of knowledge. Imagine that in the process of communicating with the patient’s family members, if the family members do not participate at all, it is not a real public participation model, but more like the deficit model. Or the public participation models will do harm to the patients when their family members, based on their own one-sided knowledge, ask doctors to choose a treatment that is totally inappropriate or impossible? For example, a patient with advanced cancer, whose general condition was very poor and life was dying, was advised to his family members to take palliative treatment. However, in the public participation model, in the process of communication between doctors and the patients’ families, the family members asked the doctor for the only way of surgical treatment to the patient, regardless of the patient’s current basic situation, then was the final treatment mean in the hands of doctors or family members? Which is the decisive factor in the following? Who is more powerful, can be persuaded by the other, or who is more scientific, more rational, or more based? Is it necessary to adopt the opinions of family members (the public) in the public participation model? These are the problems we need to think about when we apply the public participation model in medical communication.

It should be said that the model of public participation conforms to the requirements of social democratization and promotes the change of scientific communication concept, but it also faces many doubts. For example, the public participation model is more like a political science model of science and public relations than a science communication model. At the same time, this model is also regarded as having the tendency of “antiscience”. These are the questions that the public participation model needs to answer.