Anderson L
Bioethics Centre, University of Otago, Dunedin, New Zealand.
J Med Ethics. 2008 Sep;34(9):e6. doi: 10.1136/jme.2008.024794.
As an employee, a sports doctor has obligations to their employer, but also professional and widely accepted obligations of a doctor to the patient (in this case the individual team member). The conflict is evident when sports doctors are asked by an athlete to keep personal health information confidential from the coach and team management, and yet both doctor and athlete have employment contracts specifying that such information shall be shared. Recent research in New Zealand shows that despite the presence of an employment contract, there appears to be a wide range of behaviours among sports doctors when an athlete requests that information about them be kept from team management. Many seem willing to honour requests to keep health information about the athlete confidential, thereby being in breach of the employment contract, while others insist on informing team management against the wishes of the athlete. There are a number of potential solutions to this dilemma from forcing doctors to meet their contractual obligations, to limiting the expectations of the employment contract. This paper suggests that at times it may be appropriate to do both, making the position of the doctor clearer and supporting the ability of this group to resist pressure by coaches and management through having a robust code of ethics.
作为一名雇员,运动医生对其雇主负有义务,但同时作为医生,对患者(在这种情况下是单个团队成员)也负有专业且被广泛认可的义务。当运动员要求运动医生对教练和团队管理层保密其个人健康信息,而医生和运动员的雇佣合同又明确规定此类信息应共享时,冲突就显而易见了。新西兰最近的研究表明,尽管存在雇佣合同,但当运动员要求对其信息保密不让团队管理层知晓时,运动医生的行为表现却多种多样。许多人似乎愿意尊重对运动员健康信息保密的要求,从而违反雇佣合同,而另一些人则不顾运动员的意愿坚持告知团队管理层。对于这一困境有多种潜在的解决方案,从迫使医生履行合同义务到限制雇佣合同的预期。本文认为,有时两者都做可能是合适的,通过制定强有力的道德准则,使医生的立场更加明确,并支持这一群体抵制教练和管理层压力的能力。