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向患者告知真相——对犹太教资料的探讨(修订版)

[Truth telling to patients--A discussion of Jewish sources (corrected)].

作者信息

Gesundheit Benjamin, Zlotnick Eitan, Wygoda Michael, Rosenzweig Joshua P, Steinberg Avraham

出版信息

Harefuah. 2014 Oct;153(10):613-6, 623.

Abstract

Defining truth and truth-telling to patients are central topics in philosophy, law, and psychology, with many implications in medicine. In the last hundred years, with the transition from paternalistic medicine to a system in which the patient's autonomy is emphasized, the decision on the quantity and quality of medical information to be disclosed to the patient has become more complicated and requires careful consideration and special sensitivity on the part of the doctor. The Israeli Patients' Rights Act (1996] established guidelines for medical staff about telltting the truth to patients with occasional special authority delegated to the doctor to decide for the benefit of the patient at his discretion and with the approval of the institutional ethics committee, but in practice there are difficulties in implementing the Law. This article reviews a selection of sources from Jewish tradition throughout the ages that deal with truthtelling or concealing the truth in medical contexts and other contexts. Sources are drawn from the Bible, Mishna-Talmud, and halachic Literature, from which.conclusions can be drawn regarding this issue. In our opinion, these sources yield messages and values that are also relevant to the modern medical world. This is especially true in a multi-cultural environment such as Israel that requires the physician to consider the patient's background and to communicate information in accordance with his/her will, in an efficient and sensitive manner.

摘要

向患者界定真相及告知真相是哲学、法律和心理学的核心议题,在医学领域也有诸多影响。在过去的一百年里,随着从家长式医疗向强调患者自主权的体系转变,决定向患者披露医疗信息的数量和质量变得更加复杂,需要医生仔细考量并格外敏感。以色列《患者权利法》(1996年)为医务人员制定了向患者告知真相的指导方针,偶尔会赋予医生特殊权力,使其能在机构伦理委员会批准的情况下,自行决定为患者的利益着想,但在实践中该法律的实施存在困难。本文回顾了历代犹太传统中一系列涉及在医疗及其他情境中告知真相或隐瞒真相的资料来源。资料来源包括《圣经》《密西拿-塔木德》和哈拉卡文献,从中可以得出关于这个问题的结论。我们认为,这些资料来源所传达的信息和价值观在现代医疗领域也具有相关性。在像以色列这样的多元文化环境中尤其如此,这要求医生考虑患者的背景,并以高效且敏感的方式根据患者的意愿传达信息。

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