Sawicki Nadia N
Loyola University School of Law, 25 East Pearson Street, Chicago, Illinois 60611 USA.
J Clin Ethics. 2016 Fall;27(3):238-242.
The American Medical Association's (AMA's) "Opinion 1.1.7, Physician Exercise of Conscience" attempts to help physicians strike a reasonable balance between their own conscientious beliefs and their patients' medical interests in an effort to minimize harms to both. However, some ambiguity still remains as to whether the severity of harms experienced by physicians and patients is to be assessed externally (by policy makers or by a professional body like the AMA), or internally by the subjects of those harms. Conflicts between conscientious physicians' self-assessments of the moral harm associated with various actions and the AMA's external assessments of such harms are likely to lead to challenges in the implementation of some provisions of its opinion. This commentary argues, however, that provisions (b) and (e) of the opinion, which describe the information physicians should provide about their own scope of practice and about the existence of controversial procedures, are less likely to conflict with physicians' subjective assessments of moral harm, and therefore will face fewer challenges in implementation.
美国医学协会（AMA）的“意见1.1.7，医生的良心行使”试图帮助医生在自身的良心信念与患者的医疗利益之间达成合理平衡，以尽量减少对双方的伤害。然而，对于医生和患者所经历伤害的严重程度是应由外部（政策制定者或像AMA这样的专业机构）评估，还是由这些伤害的主体进行内部评估，仍存在一些模糊之处。有良心的医生对各种行为所带来的道德伤害的自我评估与AMA对这些伤害的外部评估之间的冲突，很可能会给其意见的某些条款的实施带来挑战。然而，本评论认为，该意见的条款（b）和（e），即描述医生应提供有关其自身执业范围以及争议性程序存在情况的信息，与医生对道德伤害的主观评估冲突可能性较小，因此在实施过程中面临的挑战也会更少。
