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高科技医学的伦理、政治和社会层面:曙光与关怀。

Ethical, political, and social aspects of high-technology medicine: Eos and care.

作者信息

Zamperetti Nereo, Bellomo Rinaldo, Dan Maurizio, Ronco Claudio

机构信息

San Bortolo Hospital, Department of Anesthesia and Intensive Care Medicine, Via Rodolfi 37, 36100 Vicenza, Italy.

出版信息

Intensive Care Med. 2006 Jun;32(6):830-5. doi: 10.1007/s00134-006-0155-0. Epub 2006 Apr 14.

Abstract

OBJECTIVE

We discuss biosocial aspects of high-technology medicine (HTM) to provide a global view of the current model of medicine in the developed world and its consequences.

METHODS

We analyze changes in the concept of death and in the use and cost of HTM. The consequences of HTM on the delivery of basic medical care within and among countries are discussed. Concepts derived from Greek mythology are used to illustrate the problems associated with HTM.

RESULTS

HTM can be extremely effective in individual cases, but it poses important bioethical and biosocial problems. A major problem is related to the possibility of manipulating the process of dying and the consequent alteration in the social concept of death, which, if not carefully regulated, risks transforming medicine into an expensive way of pursuing pointless dreams of immortality (myth of Eos). Another problem is related to the extraordinary amount of resources necessary for HTM. This model of medicine (which is practiced daily) has limited sustainability, can work only in highly developed countries, may contribute to unequal access to health care, and has negligible positive impact on global health and survival.

CONCLUSIONS

HTM poses very important biosocial questions that need to be addressed in a wider and transparent debate, in the best interest of society and HTM as well.

摘要

目的

我们探讨高科技医学(HTM)的生物社会层面,以全面了解发达国家当前的医学模式及其后果。

方法

我们分析死亡概念以及高科技医学的使用和成本的变化。讨论了高科技医学对国家内部和国家之间基本医疗服务提供的影响。源自希腊神话的概念被用来阐释与高科技医学相关的问题。

结果

高科技医学在个别案例中可能极其有效,但它引发了重要的生物伦理和生物社会问题。一个主要问题与操纵死亡过程的可能性以及随之而来的社会死亡概念的改变有关,如果不加以谨慎规范,存在将医学转变为追求无意义永生梦想(厄俄斯神话)的昂贵方式的风险。另一个问题与高科技医学所需的大量资源有关。这种医学模式(每天都在实践)可持续性有限,只能在高度发达国家开展,可能导致医疗保健获取的不平等,并且对全球健康和生存的积极影响微不足道。

结论

高科技医学提出了非常重要的生物社会问题,需要在更广泛和透明的辩论中加以解决,这也是为了社会和高科技医学的最大利益。

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