Montero Santiago Alvarez
Centro de Salud de Torrelodones, Madrid, España.
Aten Primaria. 2010 Oct;42(10):528-33. doi: 10.1016/j.aprim.2009.12.011. Epub 2010 Mar 20.
From the beginning, family medicine (FM) has brought health care nearer to the population. A crisis in FM is a good time to look at the social expectations and to reformulate and to strengthen the principles that guide the specialty. An ethical reflection is presented on what to do from the microcosm of daily practice. Bureaucracy and trivialities cause a moral decline which prevents FM from offering the specific service that it should. Its visualisation as doorman to the system, a mere filter of banalities, an administration area or as a handkerchief for the system to cry on, draws a socially unacceptable caricature. It is vital for FM to reach an effective compromise preferably directed at the most vulnerable groups or individuals. But it also urgently needs a sense of recovery as an area of human promotion, in which the professionals do not lose their moral capacity to have something to desire, want, achieve and enjoy.
从一开始,家庭医学(FM)就使医疗保健更贴近民众。家庭医学面临危机之际,正是审视社会期望、重新制定并强化指导该专业的原则的好时机。本文从日常实践的微观层面进行了伦理思考。官僚主义和琐事导致道德滑坡,使家庭医学无法提供其应有的特定服务。将其视为系统的门卫、仅仅是琐事的过滤器、行政区域或系统哭泣时的手帕,描绘出一幅社会无法接受的漫画形象。对家庭医学而言,至关重要的是达成有效的妥协,最好针对最弱势群体或个人。但它也迫切需要恢复作为人类促进领域的意识,在这个领域中,专业人员不会丧失拥有渴望、追求、实现和享受事物的道德能力。