Rancich A M, Pérez M L, Gelpi R J, Mainetti J A
Departamento de Graduados, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, Argentina.
Gac Med Mex. 1999 May-Jun;135(3):345-51.
The principles of beneficence and no-maleficence, already set forth in the Hippocratic Oath, have been the foundation of medical ethics for the last twenty-five centuries. The principle of beneficence is currently maintained in most wordings of the pledges of medical schools of the United States, Canada and Argentina; it is not the same with the principle of non-maleficence. The aim of this paper is to determine whether these principles are described in medical oaths at different times. These principles did not remain in an oaths. Of twenty-nine analyzed texts, nine describe both principles simultaneously, eleven only mention beneficence; three only express non-maleficence, and six indicate neither of them. Most wordings that describe these principles are modifications of the Hippocratic Oath. Two contemporary wordings describe the achievement of the greatest benefit with minimum harm. Two current wording also subordinate the principle of beneficence to the principle of respect for the patient's autonomy, and eight wordings indicate not only patients' benefit in particular but that of society in general. It is not possible to ignore that it is no enough to fulfill only these two principles. Physicians should encourage the development of patients' responsibility in managing their own health and respect their autonomy.
希波克拉底誓言中早已阐明的行善和不伤害原则，在过去两千五百年里一直是医学伦理的基础。美国、加拿大和阿根廷医学院誓言的大多数措辞中都保留了行善原则；而不伤害原则的情况则不同。本文旨在确定这些原则在不同时期的医学誓言中是否有所描述。这些原则并未一直保留在誓言中。在分析的29篇文本中，9篇同时描述了这两个原则，11篇仅提及行善原则；3篇仅表达了不伤害原则，6篇则未提及任何一个原则。描述这些原则的大多数措辞都是对希波克拉底誓言的修改。有两个当代措辞描述了以最小的伤害实现最大的益处。还有两个当前措辞将行善原则置于尊重患者自主权原则之下，8个措辞不仅指出了对患者个体的益处，还指出了对整个社会的益处。不可忽视的是，仅践行这两个原则是不够的。医生应鼓励患者在管理自身健康方面培养责任感，并尊重他们的自主权。
