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医学行善、不伤害和患者福祉。

Medical Beneficence, Nonmaleficence, and Patients' Well-Being.

机构信息

Associate Professor, Center for the Philosophy of Freedom, University of Arizona, Tuscon, Arizona USA.

出版信息

J Clin Ethics. 2022 Spring;33(1):23-28.

Abstract

This article critically analyzes the principle of beneficence and the principle of nonmaleficence in clinical medical ethics. It resists some recent skepticism about the principle of nonmaleficence, and then seeks to explain its role in medicine. The article proposes that the two principles are informed by different accounts of what is in the patient's best interests. The principle of beneficence is tied to the patient's best overall interests, whereas the principle of nonmaleficence is tied to the patient's best medical interests only. The article argues that the principle of nonmaleficence takes priority over the principle of beneficence in that it filters the treatment options that are appropriately subject to the principle of beneficence. Understanding how both principles can play an important role in medical practice, and how they relate when they come into conflict, can help clinicians to avoid certain mistakes in thinking about their duties to their patients.

摘要

本文批判性地分析了临床医学伦理中的“行善原则”和“不伤害原则”。文中抵制了近来对“不伤害原则”的一些怀疑,并试图解释它在医学中的作用。文章提出,这两个原则是基于对患者最佳利益的不同解释。“行善原则”与患者的整体最佳利益相关,而“不伤害原则”仅与患者的最佳医疗利益相关。文章认为,“不伤害原则”优先于“行善原则”,因为它过滤了那些适当适用于“行善原则”的治疗方案。理解这两个原则如何在医疗实践中发挥重要作用,以及它们在冲突时如何相互关联,可以帮助临床医生避免在思考对患者的职责时犯某些错误。

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