Pellegrino E D
Center for the Advanced Study of Ethics, Georgetown University, Washington, D. C.
Bull Pan Am Health Organ. 1990;24(4):361-71.
The emergence of autonomy as a sociopolitical, legal, and moral concept has profoundly influenced medical ethics. It has shifted the center of decision-making from the physician to the patient and reoriented the whole physician-patient relationship toward a relationship more open, more honest, and more respectful of the dignity of the person of the patient. But autonomy is insufficient to guarantee the nuances and the full meanings of respect for persons in medical transactions. As a foundation for medical relationships, the concept of integrity is richer, more fundamental, and more closely tied to what it is to be a whole human person. So, for reasons outlined in this article, we should deepen our grasp of the notion that autonomy depends upon preserving the integrity of persons and that both integrity of persons and autonomy depend on the physician.
自主性作为一种社会政治、法律和道德概念的出现，对医学伦理产生了深远影响。它将决策中心从医生转移到了患者，并使整个医患关系重新定位为一种更开放、更诚实、更尊重患者人格尊严的关系。但自主性不足以保证医疗交易中尊重人的细微差别和全部意义。作为医疗关系的基础，诚信概念更为丰富、更为根本，并且与成为完整的人更为紧密相关。因此，基于本文所述的原因，我们应该加深对这一观念的理解，即自主性取决于维护人的诚信，而人的诚信和自主性都依赖于医生。
