Bowden P
J Med Ethics. 1976 Dec;2(4):163-72. doi: 10.1136/jme.2.4.163.
It is argued in this paper that a doctor cannot serve two masters. The work of the prison medical officer is examined and it is shown that his dual allegiance to the state and to those individuals who are under his care results in activities which largely favour the former. The World Health Organisation prescribes a system of health ethics which indicates, in qualitative terms, the responsibility of each state for health provisions. In contrast, the World Medical Association acts as both promulgator and guardian of a code of medical ethics which determines the responsibilities of the doctor to his patient. In the historical sense medical practitioners have always emphasized the sanctity of the relationship with their patients and the doctor's role as an expert witness is shown to have centered around this bond. The development of medical services in prisons has focused more on the partnership between doctor and institution. Imprisonment in itself could be seen as prejudicial to health as are disciplinary methods which are more obviously detrimental. The involvement of medical practitioners in such procedures is discussed in the light of their role as the prisoner's personal physician.
本文认为,医生不能侍奉两个主人。文中审视了监狱医务人员的工作,结果表明,他们对国家和对其照顾的个人的双重忠诚导致其行为在很大程度上偏袒前者。世界卫生组织规定了一套健康伦理体系,从质量方面表明了每个国家在提供医疗保健方面的责任。相比之下,世界医学协会既是医学伦理准则的颁布者,也是其守护者,该准则规定了医生对患者的责任。从历史角度看,执业医生一直强调与患者关系的神圣性,并且医生作为专家证人的角色一直围绕着这种关系。监狱医疗服务的发展更多地集中在医生与机构之间的伙伴关系上。监禁本身可能被视为对健康有害,那些更明显有害的惩戒方法也是如此。鉴于医生作为囚犯私人医生的角色,本文讨论了他们在这些程序中的参与情况。