Montanari Vergallo G, Busardò F P, Zaami S, Marinelli E
Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Rome, Italy.
Eur Rev Med Pharmacol Sci. 2016;20(3):575-80.
Eight years since the last revision, in May 2014 the Italian code of medical ethics has been updated. Here, the Authors examine the reform in the light of the increasing difficulties of the medical profession arising from the severity of the Italian law Courts. The most significant aspects of this new code are firstly, the patient's freedom of self-determination and secondly, risk prevention through the disclosure of errors and adverse events. However, in both areas the reform seems to be less effective if we compare the ethical codes of France, the United Kingdom and the United States. In particular, the non-taking into consideration of the said code quality standards and scientific evidence which should guide doctors in their clinical practice is to say the least questionable. Since these are the most significant changes in the new code, it seems inevitable to conclude that the 2014 edition is essentially in line with previous versions. Now more than ever it is necessary that medical ethics acknowledges that medicine, society and medical jurisprudence have changed and doctors must be given new rules in order to protect both patients' rights and dignity of the profession. The physician's right to refuse to perform treatment at odds with his own clinical beliefs cannot be the only mean to safeguard the dignity of the profession. A clear boundary must also be established between medicine and professionalism as well as the criteria in determining the scientific evidences that physicians must follow. This has not been done in the Italian code of ethics, despite all the controversy caused by the Stamina case.
自上次修订以来已过去八年，2014年5月意大利医学伦理准则进行了更新。在此，作者们从意大利法院的严苛导致医学职业面临日益增加的困难这一角度审视了此次改革。这部新准则最显著的方面，其一为患者的自我决定权，其二为通过披露错误和不良事件进行风险预防。然而，如果将其与法国、英国和美国的伦理准则相比较，在这两个领域改革似乎成效欠佳。尤其是，未考虑到应由质量标准和科学证据来指导医生临床实践这一点，至少是值得质疑的。鉴于这些是新准则中最重大的变化，似乎不可避免地得出结论，即2014年版本质上与先前版本一致。现在比以往任何时候都更有必要让医学伦理承认医学、社会和医学法学已经发生了变化，并且必须为医生制定新的规则，以保护患者权利和职业尊严。医生拒绝实施与其自身临床信念相悖的治疗的权利不能成为维护职业尊严的唯一手段。还必须在医学与职业精神之间以及确定医生必须遵循的科学证据的标准方面明确界定界限。尽管“耐力案”引发了诸多争议，但意大利伦理准则中并未做到这一点。
