Westerholm Peter
National Institute for Working Life, SE-113 91, Stockholm, Sweden.
Ind Health. 2007 Jan;45(1):19-25. doi: 10.2486/indhealth.45.19.
In this paper, the foundations of professional ethics in occupational health care is described and discussed. After an introduction reminding of the global developments of world economy, communications and trade and reference to cultural and social developments, reference is given the four basic ethical criteria of biomedical ethics of beneficence ("doing good"), non-malfeasance (avoidance of harm), autonomy (integrity) and Justice/Equity-The "Appletown consensus" of 1989. These criteria provide the basis for current thinking and practice in health professions of Western Europe. The principles of ethical analysis, as currently practiced is described using a practical case scenario drawn from experience of challenging tasks for Occupational Health Services in Western Europe. Specific challenges to professional ethics are discussed-the growth of knowledge in subjects and academic disciplines relevant to occupational health and the multiple loyalties of occupational health professionals. The principles of ethical codes and their implementation are touched on. In conclusion, the universality of professional ethical principles of bioethics-including occupational health-is discussed in observing global inter-cultural commonalities and convergence on ethical criteria of central importance. Emphatic recommendation is given to continue inter-cultural exchanges with a view to improve understanding of impact of contextual and cultural factors on ethics in professional occupational health practice.
本文描述并讨论了职业卫生保健中职业道德的基础。在引言部分回顾了世界经济、通信和贸易的全球发展情况，并提及文化和社会发展之后，引入了生物医学伦理的四个基本道德标准，即行善（“做好事”）、不伤害（避免伤害）、自主（正直）以及公正/公平——1989年的“苹果镇共识”。这些标准为西欧卫生专业当前的思维和实践提供了基础。文中使用一个从西欧职业卫生服务面临的具有挑战性任务的经验中选取的实际案例场景，描述了当前实践中道德分析的原则。讨论了职业道德面临的具体挑战——与职业健康相关学科和学术领域知识的增长以及职业健康专业人员的多重忠诚。还涉及了道德规范的原则及其实施。总之，在观察全球跨文化共性以及在至关重要的道德标准上的趋同现象时，讨论了生物伦理职业道德原则（包括职业健康领域）的普遍性。着重建议继续开展跨文化交流，以增进对背景和文化因素对职业卫生专业实践中伦理影响的理解。
