Furger F
Institut für Christliche Sozialwissenschaften, Münster.
Radiologe. 1990 Oct;30(10):502-5.
In bygone centuries, the maxim of doing no harm was enough to define intervention by a doctor; now, in contrast, dealing with the possibilities opened up by modern medical technology demands increasingly careful observance of the moral virtue of the correct degree of moderation. The present ethical challenge when medical decisions have to be made is not simply to be allowed to do everything possible. The art of medical intervention has to be exercised with due respect for the concept of temperantia medici, which, however, has to have significance not only in the concrete individual case, but also in the wider context of social ethics, that is to say for health services as a whole. The anonymity resulting from increasing specialization, the tendency to think impersonally in terms of probabilities following the introduction of screening programmes with routine examinations and the connected legalization of medicine are addressed as particularly important problems in this respect; all these trends beset the personal doctor-patient relationship with difficulties and suggest the procedure with the greatest technological input as the safest and most convenient solution, thus making it difficult to find the correct degree of moderation. As a result of all this, modern medicine is evidently being regarded with increasing scepticism by wide sections of the population, a situation demanding an ethically appropriate return to the old medical virtue of moderation.
在过去的几个世纪里,“不伤害”这一准则足以界定医生的干预行为;而如今,与之形成对比的是,应对现代医学技术带来的各种可能性需要越来越谨慎地遵循适度这一道德美德。当前,在必须做出医疗决策时面临的伦理挑战并非仅仅是被允许尽一切可能。医疗干预的艺术必须在充分尊重“医生适度”这一概念的前提下加以运用,然而,这一概念不仅在具体的个案中具有重要意义,在更广泛的社会伦理背景下,也就是对整个医疗服务而言,也必须具有重要意义。在这方面,日益专业化导致的匿名性、随着引入常规检查的筛查项目后倾向于从概率角度进行非个人化思考以及医学的相关合法化被视为特别重要的问题;所有这些趋势给个人医患关系带来了困难,并将技术投入最大的程序视为最安全、最便捷的解决方案,从而难以找到正确的适度程度。鉴于所有这些情况,现代医学显然正受到广大民众越来越多的怀疑,这种情况要求在伦理上适当地回归古老的适度医疗美德。