Body R, Foex B
Emergency Medicine Research Group, Research Office, Emergency Department, Manchester Royal Infirmary, Manchester, UK.
Emerg Med J. 2009 Apr;26(4):238-40. doi: 10.1136/emj.2008.064303.
Diagnosis is arguably the cornerstone of medicine. Without at least some form of diagnosis the practice of medicine would not be possible. This narrative review explores common philosophical assumptions and challenges the notion that a certain diagnosis can ever be made. The idealistic concept of "primum non nocere" is discussed, and whether the utilitarian goal of achieving "the greatest happiness for the greatest number" is a feasible or preferable alternative is considered. It is concluded that utilitarianism is inescapably intertwined with modern medical practice. Suggestions are presented to further the understanding of diagnostic medicine by embracing its principles.
诊断可以说是医学的基石。没有至少某种形式的诊断，医学实践就不可能存在。这篇叙述性综述探讨了常见的哲学假设，并对某种诊断是否能够做出这一观点提出了质疑。文中讨论了“首要的是不伤害”这一理想主义概念，并思考了实现“最大多数人的最大幸福”这一功利主义目标是否是一个可行或更可取的选择。结论是，功利主义与现代医学实践不可避免地交织在一起。文中提出了一些建议，以通过接受诊断医学的原则来增进对它的理解。
