University of British Columbia, Vancouver, British Columbia, Canada.
University of Alberta, Edmonton, Alberta, Canada.
J Med Philos. 2022 Feb 8;47(1):54-71. doi: 10.1093/jmp/jhab034.
"Intervention" is not synonymous with "care." For an intervention to constitute care-which patients should have a right to access-it must be technically feasible and licit. Now these criteria do not prove sufficient; numerous archaic interventions remain feasible and legally permissible, yet are now bywords for spurious care. Therefore, we propound another necessary condition for an intervention to become care: the physician must rationally judge the intervention to be conducive to the patient's good. Consequently, the right of access-to-care relies on physicians being free to practice medicine in accord with their consciences, conscience being the rational faculty with which they judge the reasonableness of even mundane medical decisions. Since physicians operate as part of a community, it is further necessary to consider when central bodies may reasonably compel physicians to engage in interventions that the physician believes are not consistent with the patient's good and/or are not congruent with the purposes of medicine.
“干预”与“关怀”并非同义词。为使干预构成关怀——患者应有权获得关怀——它必须在技术上可行且合法。现在，这些标准并不充分；许多陈旧的干预措施在技术上仍然可行且合法，但现在却成了虚假关怀的代名词。因此，我们提出了干预成为关怀的另一个必要条件：医生必须理性判断干预对患者有益。因此，获得关怀的权利取决于医生是否能够根据自己的良心行医，而良心是他们判断即使是平凡的医疗决策是否合理的理性能力。由于医生是作为一个共同体的一部分运作的，因此还需要考虑在什么情况下，中央机构可以合理地要求医生进行干预，而医生认为这些干预不符合患者的利益和/或不符合医学的目的。
