Komesaroff Paul A, Kerridge Ian H
Monash University, Melbourne, VIC, Australia.
Med J Aust. 2009 Feb 16;190(4):204-5. doi: 10.5694/j.1326-5377.2009.tb02744.x.
In preparation for a national medical registration system, the Australian Medical Council has proposed a code of conduct ("the Code") that provides a comprehensive description of how doctors should behave. While containing much that will be widely acceptable to doctors, the Code has some major weaknesses: Many of its provisions focus on values and aspirations of a very general nature and will be impossible to enforce. It is based on a narrow, culturally specific view of medicine and ethics that does not reflect the multicultural diversity of Australian society. It confuses the roles of ethics and law in medicine, leading to inappropriate and mistaken injunctions about decision making and responsibilities. In place of the existing, effective, democratic and devolved (if imperfect) system of ethical and professional decision making, it threatens to establish a centralised, authoritarian regime. Because of its limited, ideological view of medicine, its implementation would impoverish medical practice and erode the ability to respond to individual circumstances and needs.
为筹备全国医疗注册系统,澳大利亚医学委员会提出了一项行为准则(“准则”),该准则全面描述了医生应如何行事。虽然其中许多内容会被医生广泛接受,但该准则存在一些重大缺陷:其许多条款侧重于非常笼统的价值观和抱负,无法执行。它基于对医学和伦理的狭隘、特定文化视角,没有反映澳大利亚社会的多元文化多样性。它混淆了医学中伦理和法律的角色,导致关于决策和责任的不当和错误禁令。它非但没有采用现有的、有效、民主且分散(尽管并不完美)的伦理和专业决策系统,反而有可能建立一个集权、专制的体制。由于其对医学的有限、意识形态化观点,其实施将使医疗实践变得贫乏,并削弱应对个体情况和需求的能力。