Lisanti Christopher, Christiansen Sandy
Department of Radiology, Brooke Army Medical Center, Fort Sam Houston, TX, USA.
Department of Radiology & Radiological Sciences, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
Linacre Q. 2020 Aug;87(3):334-340. doi: 10.1177/0024363920920397. Epub 2020 May 12.
What is the purpose of medicine? This fundamental question is at the heart of the criticisms faced by pregnancy centers (PCs) and accusations that they are unethical. PCs maintain that the purpose of medicine is to treat and prevent disease. Because pregnancy is not a disease, PCs do not advocate for elective abortion or contraceptives. PCs view the function of values (e.g., autonomy) as constraints upon physicians that prevent physical and ethical harms. Their critics either embrace an ill-defined purpose of medicine such as promoting well-being or conflate the value of autonomy with medicine's purpose. This leads to a subjective view of medicine and changes the relationship from physician-patient to vendor-customer. This subjective nature along with its attendant vendor-customer relationship cannot solve for current or future ethical problems such as sex-selective abortion and its fatal discrimination against females.
Pregnancy Centers embrace a traditional "treat and prevent disease" purpose of medicine. This clear and objective purpose logically leads to not advocating for abortion or contraceptives. The authors outline a coherent ethical structure outlining the role values play in regards to this purpose. This is contrasted with the current ill-defined purpose within medicine today that has led to an inconsistent change of the physician-patient relationship to a vendor-customer one, ethical incoherence, and several attendant harms, most notably sex-selective abortion.
医学的目的是什么?这个基本问题是怀孕咨询中心(PCs)面临批评以及被指责不道德的核心所在。怀孕咨询中心认为医学的目的是治疗和预防疾病。由于怀孕并非疾病,怀孕咨询中心不提倡选择性堕胎或使用避孕药具。怀孕咨询中心将价值观(如自主性)的作用视为对医生的约束,以防止身体和道德伤害。其批评者要么接受一个定义不明确的医学目的,如促进幸福,要么将自主性的价值与医学目的混为一谈。这导致了对医学的主观看法,并将医患关系转变为供应商 - 客户关系。这种主观性质及其伴随的供应商 - 客户关系无法解决当前或未来的伦理问题,如性别选择性堕胎及其对女性的致命歧视。
怀孕咨询中心秉持传统的“治疗和预防疾病”的医学目的。这个清晰且客观的目的在逻辑上导致不提倡堕胎或使用避孕药具。作者概述了一个连贯的伦理结构,阐述了价值观在这一目的方面所起的作用。这与当今医学中目前定义不明确的目的形成对比,后者导致了医患关系不一致地转变为供应商 - 客户关系、伦理上的不连贯以及一些随之而来的危害,最显著的是性别选择性堕胎。