Brandt-Rauf P W
Columbia-Presbyterian Medical Center, New York, NY 10032.
Br J Ind Med. 1989 Jan;46(1):63-6. doi: 10.1136/oem.46.1.63.
The practice of occupational medicine has been portrayed as being fraught with ethical conflict and yet this problem has received little systematic study. A question and case study survey of a randomly selected cohort of members of the American Occupational Medical Association has been performed to examine the extent and nature of this problem in occupational medicine practice in the United States. The results indicate a strong reliance on traditional medical role models in responding to ethical conflict but with significant underlying tension between more deontological physician-patient approaches and more teleological public health approaches. These results have significant implications for the synthesis of bioethical theories based on a perceived complementarity of ethical reality, as well as suggesting important improvements in future occupational medicine training.
职业医学实践被描述为充满伦理冲突，但这个问题几乎没有得到系统研究。对美国职业医学协会成员的一个随机抽取队列进行了问卷调查和案例研究，以考察美国职业医学实践中这一问题的程度和性质。结果表明，在应对伦理冲突时，强烈依赖传统医学角色模式，但在更注重义务论的医患方法和更注重目的论的公共卫生方法之间存在明显的潜在紧张关系。这些结果对于基于伦理现实的感知互补性来综合生物伦理理论具有重要意义，同时也为未来职业医学培训的重要改进提供了建议。
