Tröhler U
Institut für Geschichte der Medizin, Georg-August-Universität, Göttingen.
Schweiz Rundsch Med Prax. 1992 Oct 27;81(44):1307-12.
A historical follow-up using three examples--euthanasia, choice of therapy for tuberculosis of bones and articulations and economic management of a medical office reveals that comprehensive timeless medical ethics independent from cultural and social influences ('hippocratic oath') do not exist. There are, however persistent as well as increasingly new fields of conflict in daily practise. The latter are partly related to increased medical efficiency. Deficiencies in explicit ethic reflexions and empiric research for coping with such problems led to interdisciplinary medico-ethical work groups and journals over the last years. In this context traditional subjective ethics of care founded on altruism still remain important: The present essay shows, why the new objective and the older subjective approach to moral dimensions of healing professions are mutually founded on each other and should converge in the course of a decision process.
一项基于三个例子的历史追踪——安乐死、骨关节结核的治疗选择以及医疗诊所的经济管理——表明,不受文化和社会影响的全面且永恒的医学伦理(“希波克拉底誓言”)并不存在。然而,在日常实践中存在着持续以及日益新出现的冲突领域。后者部分与医疗效率的提高有关。在过去几年里,由于应对此类问题的明确伦理反思和实证研究存在不足,导致了跨学科的医学伦理工作小组和期刊的出现。在这种背景下,基于利他主义的传统主观护理伦理仍然很重要:本文展示了为何针对治疗行业道德维度的新的客观方法和旧的主观方法相互依存,并且在决策过程中应该相互融合。