Cappagh National Orthopaedic Hospital, Dublin, Ireland.
Br J Sports Med. 2010 Feb;44(3):175-8. doi: 10.1136/bjsm.2009.068056. Epub 2009 Nov 29.
There are many ethical dilemmas that are unique to sports medicine because of the unusual clinical environment of caring for players within the context of a team whose primary objective is to win. Many of these ethical issues arise because the traditional relationship between doctor and patient is distorted or absent. The emergence of a doctor-patient-team triad has created a scenario in which the team's priority can conflict with or even replace the doctor's primary obligation to player well-being. As a result, the customary ethical norms that provide guidelines for most forms of clinical practice, such as patient autonomy and confidentiality, are not easily translated in the field of sports medicine. Sports doctors are frequently under intense pressure, whether implicit or explicit, from management, coaches, trainers and agents, to improve performance of the athlete in the short term rather than considering the long-term sequelae of such decisions. A myriad of ethical dilemmas are encountered, and for many of these dilemmas there are no right answers. In this article, a number of ethical principles and how they relate to sports medicine are discussed. To conclude, a list of guidelines has been drawn up to offer some support to doctors facing an ethical quandary, the most important of which is 'do not abdicate your responsibility to the individual player.''I am in blood Stepp'd in so far that, should I wade no more, Returning would be as tedious as to go o'er' -Macbeth: Act III, Scene IV, William Shakespeare.
由于照顾运动员的临床环境不寻常，而且团队的主要目标是获胜，因此运动医学存在许多独特的伦理困境。许多这些伦理问题是因为医生和患者之间的传统关系被扭曲或不存在。医生-患者-团队三方关系的出现，使得团队的优先事项可能与医生对运动员福祉的首要义务发生冲突，甚至取代后者。因此，为大多数临床实践形式提供指导方针的常规伦理规范在运动医学领域不易转化。体育医生经常面临来自管理层、教练、训练师和经纪人的巨大压力，无论是明确的还是隐含的，要求他们在短期内提高运动员的表现，而不是考虑此类决策的长期后果。遇到了无数的伦理困境，对于其中许多困境，并没有正确的答案。在本文中，讨论了一些与运动医学相关的伦理原则及其关系。最后，列出了一些指导方针，为面临伦理困境的医生提供一些支持，其中最重要的是“不要放弃对每个运动员的责任。”“我已经涉足太深，如果我不再前进，返回将像重新走过一样乏味。”——麦克白：第三幕，第四场，威廉·莎士比亚。
