Rosenstock L, Hagopian A
Ann Intern Med. 1987 Oct;107(4):575-80. doi: 10.7326/0003-4819-107-4-575.
The internist, expected to play an increasing role in occupational medicine, is likely to encounter ethical dilemmas in treating working patients, including those involving loyalty, confidentiality, reporting known or suspected occupational hazards and diseases, and maintaining awareness about occupational health factors. Many of these dilemmas become realized when the internist integrates occupational health services into general internal medicine practice, particularly when these services are important to employment decisions, such as the preemployment and periodic examinations. Appropriate responses to these dilemmas and the situations from which they arise can be formulated, based on accepted ethical and legal principles.
内科医生有望在职业医学中发挥越来越重要的作用，在治疗在职患者时可能会遇到伦理困境，包括涉及忠诚、保密、报告已知或疑似职业危害与疾病，以及保持对职业健康因素的认知等方面。当内科医生将职业健康服务纳入普通内科实践时，尤其是当这些服务对就业决策（如入职前和定期检查）很重要时，许多此类困境就会显现出来。基于公认的伦理和法律原则，可以制定出对这些困境及其产生情境的适当应对措施。
