Zwi A B
London School of Hygiene and Tropical Medicine.
Soc Sci Med. 1987;25(6):649-57. doi: 10.1016/0277-9536(87)90092-x.
A fundamental aim of medicine is to protect and promote health. The practice of medicine has, however, been used to promote political aims which may be detrimental to health. The article attempts to isolate the ways in which political abuses may interfere with good medical practice: by allowing health policies to be influenced by undemocratic political considerations; by using health services to reward or punish political supporters or opponents; by direct medical involvement in political acts which contradict accepted medical ethics; and by the support which conventional medical practises give to perpetuating inequalities in health and social services. Each of these is examined with the use of a number of examples. The ways in which medical personnel have opposed the political abuse of medicine is explored by a brief review of the opposition of Chilean doctors to torture, the involvement of South African doctors in opposing the abuse of health services in perpetuating apartheid, and the growing medical movement in opposition to nuclear war. Some comments concerning the monitoring of a multitude of medical disciplines which are open to political abuse are made. The purpose of the paper is primarily to stimulate debate around this important issue and it does not attempt to provide a comprehensive review of the political abuse of medicine.
医学的一个基本目标是保护和促进健康。然而，医学实践却被用于实现可能对健康有害的政治目标。本文试图梳理出政治滥用可能干扰良好医疗实践的方式：让健康政策受不民主的政治考量影响；利用医疗服务奖励或惩罚政治支持者或反对者；医疗直接参与违背公认医学伦理的政治行为；以及传统医疗实践对健康和社会服务领域长期存在的不平等现象起到推波助澜的作用。文中通过若干实例对上述每一种情况进行了审视。通过简要回顾智利医生反对酷刑的行动、南非医生参与反对利用医疗服务延续种族隔离的行为以及日益壮大的反对核战争的医学运动，探讨了医务人员反对医学政治滥用的方式。文中还对众多易受政治滥用的医学学科的监管发表了一些看法。本文的目的主要是激发围绕这一重要问题的辩论，并非试图对医学的政治滥用进行全面综述。
