Bioethics and Health Law Center, Mississippi College School of Law, Jackson, MS.
Chest. 2011 Mar;139(3):669-673. doi: 10.1378/chest.10-2532.
As part of a larger series addressing the intersection of law and medicine, this essay is the first of two introductory pieces. This article explores the nature of the physician-patient relationship and of the practice of medicine dating from the Hippocratic tradition to the end of the 19th century, a period during which a beneficence-based medical ethic remained relatively stable. The medical literature dating from the Hippocratic texts to the early codes of the American Medical Association did not include a meaningful role for the patient in the decision-making process. In fact, the practice of benevolent deception--the deliberate withholding of any information thought by the physician to be detrimental to the patient's prognosis--was encouraged. However, as philosophers identified an inherent value in respecting patient self-determination and the law imposed a duty on physicians to obtain informed consent, 2,400 years of relative stability under the beneficence model gave way to the autonomy model.
作为一个更大的法律与医学交叉问题系列的一部分，本文是两篇介绍性文章中的第一篇。本文探讨了从希波克拉底传统到 19 世纪末的医患关系和医学实践的性质，在这段时期，以行善为基础的医学伦理相对稳定。从希波克拉底文本到美国医学协会早期法规的医学文献中，并没有为患者在决策过程中提供有意义的角色。事实上，善意欺骗的做法——故意隐瞒医生认为对患者预后不利的任何信息——是被鼓励的。然而，随着哲学家确定尊重患者自主决定的内在价值，以及法律规定医生有义务获得知情同意，行善模式下 2400 年的相对稳定让位于自主模式。
