Ravez Laurent, Rennie Stuart, Yemesi Robert, Chalachala Jean-Lambert, Makindu Darius, Behets Frieda, Fox Albert, Kashamuka Melchior, Kayembé Patrick
Centre de Bioéthique, Institut Espace Philosophique de Namur (ESPHIN), Université de Namur, Belgique.
Department of Social Medicine and Center for Bioethics, University of North Carolina at Chapel Hill, Êtats-Unis.
Can J Bioeth. 2019;2(2). doi: 10.7202/1062303ar. Epub 2019 Mar 20.
For several years, the Democratic Republic of Congo has been the scene of strikes by the country's doctors. The strikers' demands are essentially financial and statutory and are intended to put pressure on the government. In this country, as is the case almost everywhere in the world, medical strikes are allowed. Every worker has the right to denounce by strike working conditions that are considered unacceptable. But are doctors just like any other workers? Do they not have particular moral obligations linked to the specificities of their profession? To shed light on these questions, the authors of this article propose three essential moral benchmarks that can be generalized to medical strike situations elsewhere in the world. The first concerns the recognition of the right to strike for doctors, including for strictly financial reasons. Health professionals cannot be asked to work in inhuman working conditions or without a salary to support their families. The second benchmark argues that it is unacceptable for this right to strike to be exercised if it sacrifices the most vulnerable patients and thus denies the very essence of the medical profession. A third benchmark complicates the reflection by reminding us that the extreme dilapidation of the Congolese health system makes it impossible to organise a minimum quality service in the event of a strike. To overcome these difficulties, we propose a national therapeutic alliance between doctors and citizens to put patients back at the centre of the health system's concerns.
多年来，刚果民主共和国一直是该国医生罢工的舞台。罢工者的诉求主要是经济和法定方面的，旨在向政府施压。在这个国家，就像世界上几乎所有地方一样，医疗罢工是被允许的。每个工人都有权通过罢工来谴责被认为不可接受的工作条件。但医生和其他工人一样吗？他们难道没有与职业特殊性相关的特殊道德义务吗？为了阐明这些问题，本文作者提出了三个基本的道德基准，这些基准可以推广到世界其他地方的医疗罢工情况。第一个基准涉及承认医生罢工的权利，包括纯粹出于经济原因。卫生专业人员不能被要求在不人道的工作条件下工作，或者没有薪水来养家糊口。第二个基准认为，如果罢工牺牲了最脆弱的患者，从而违背了医疗行业的本质，那么行使罢工权利是不可接受的。第三个基准使思考变得复杂，它提醒我们，刚果卫生系统的极度破败使得在罢工情况下无法组织起最低质量的服务。为了克服这些困难，我们提议医生和公民建立全国性的治疗联盟，将患者重新置于卫生系统关注的中心。
