Abstract

DOMINGUES, Sara Gonçalo. The medical act as symbolic interaction. Rev Port Med Geral Fam [online]. 2019, vol.35, n.6, pp.496-500. ISSN 2182-5173.  https://doi.org/10.32385/rpmgf.v35i6.12060.

Introduction: The medical consultation is a social gathering, based on symbolic interactionist theory and ethical theory. Symbolic interactionism gives the concepts of social role, audience, an order of interaction and personal responsibility. The deontological, virtue and procedural ethics come from ethical theory. This case shows that the success of clinical work may be due to the effectiveness of the symbolic interactive process developed in a clinical gathering. Case report: Female teenager went to the Emergency Room (ER) due to an episode of collapse. In the past two months, she presented four similar episodes and several admissions to the ER for the same reason. She was accompanied by her mother. Symptoms were non-specific and physical examination plus complimentary tests showed no abnormalities. During the evaluation, the patient was rather anxious than we would expect from the clinical context, indicating a possible hidden cause. Her mother was then asked to leave the room. Alone with the teenager, she was again asked for any problems in her life, highlighting the importance of truth in the doctor-patient relationship. After some hesitation, she revealed that she had unprotected sexual intercourse with her boyfriend. The menstruation failed in the last two months, and she was worried about the possibility of pregnancy, but her mother was unaware of her relation. The pregnancy test was negative and she was advised to confide to her mother. Lastly, we stressed the importance of effective protection on sexual intercourse, and she was referred to her family doctor to schedule a follow-up appointment. Comments: This case emphasizes the importance of symbolic interactionism in the success of the medical consultation. It explores the social roles played by the actors of a clinical gathering and recognizes the importance of non-verbal communication in the context of ambiguity and uncertainty of the patient’s hidden information.

Keywords : Physician-patient relationship; Nonverbal communication; Clinical ethics.

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