Rancich Ana María, Pérez Marta Lucía, Morales Celina, Gelpi Ricardo Jorge
Institute of Cardiovascular Physiopathology, Department of Pathology, Faculty of Medicine, Buenos Aires University, Argentina.
J Contin Educ Health Prof. 2005 Summer;25(3):211-20. doi: 10.1002/chp.32.
The principles of justice, beneficence, and nonmaleficence are prescriptions of the Hippocratic Oath. To fulfill them, physicians are obligated morally to lifelong learning; yet, there is little evidence that the relationship of beneficence to lifelong learning or to continuing medical education (CME) is expressed in medical oaths.
We analyzed 48 medical oaths written from the first century Ce through the present day, searching for a commitment to lifelong learning and for specification of a relationship to the principle of beneficence. Thirteen ancient and medieval and 35 modern and contemporary oaths were inventoried for source, such as corresponding to a medical school. They were sorted by those that mention the commitment toward lifelong learning and to determine their relationship with the principle of beneficence.
Of the 48 medical oaths analyzed, only 20 manifest the commitment to lifelong learning. However, most of the oaths that contain this commitment do not pertain to medical schools, with the exception of the Declaration of Geneva. Of this group, 16 also indicate the principle of beneficence. Of these 16, only 3 establish a link between both. One medical oath indicated this commitment, and none of them analyzed the relation with the principle of beneficence.
The commitment toward CME should not be absent in the present medical oaths. It is a duty and right of all physicians, and in turn, society should recognize this obligation in order to offer opportunities for the achievement of the principle of beneficence that will result in better health care.
公正、行善和不伤害原则是希波克拉底誓言的规定。为了践行这些原则,医生在道德上有终身学习的义务;然而,几乎没有证据表明行善与终身学习或继续医学教育(CME)之间的关系在医学誓言中有所体现。
我们分析了从公元1世纪至今撰写的48份医学誓言,寻找对终身学习的承诺以及与行善原则关系的具体阐述。对13份古代和中世纪誓言以及35份现代和当代誓言进行了来源清查,比如是否对应某所医学院。根据那些提及终身学习承诺的誓言进行分类,并确定它们与行善原则的关系。
在分析的48份医学誓言中,只有20份体现了对终身学习的承诺。然而,除《日内瓦宣言》外,大多数包含这一承诺的誓言并不来自医学院。在这一组中,有16份也提到了行善原则。在这16份中,只有3份建立了两者之间的联系。有一份医学誓言表明了这一承诺,但所有这些誓言都没有分析与行善原则的关系。
现行医学誓言中不应缺少对继续医学教育的承诺。这是所有医生的责任和权利,反过来,社会应该认可这一义务,以便为实现行善原则提供机会,从而带来更好的医疗保健。