Lowental U
J Med Ethics. 1979 Mar;5(1):22-5. doi: 10.1136/jme.5.1.22.
The doctor-patient relationship is examined an emphasis on the comparison between professional and moral principles. Many therapeutic measures have opposite-directed alternative steps with an equal degree of justification, so that no logical preference is attainable and conflicts ensue. Thus patients come for relief and are ordered to endure further pain and discomfort; or weaker individuals exaggerate their complaints hypochomdriacally, and thus need a great deal of understanding, yet paradoxically they are prone to receive less support than stronger ones. Further conflicts arise between our devotion to human well-being and dignity, and our obligation to disrespect some of their rights for self-determination. Furthermore, various dutifully performed doctoring activities run counter to our own social needs and interests; last, but not least, human imperfection colours some of our decisions, putting a definite blemish on their value. In conclusion, physicians must bear the constant burden of paradoxically-opposed alternatives, and they confront pitfalls of worongdoing at every therapeutic step. Their only guidelines are intuition and professional dedication.
医患关系在强调专业原则与道德原则比较的基础上进行审视。许多治疗措施都有方向相反但具有同等合理性的替代步骤,因此无法获得逻辑上的偏好,从而引发冲突。这样一来,患者前来寻求缓解,却被要求忍受更多的痛苦和不适;或者较为脆弱的个体疑病性地夸大其主诉,因此需要大量的理解,但矛盾的是,他们往往比强壮的个体得到的支持更少。我们对人类福祉和尊严的奉献与我们在某些情况下无视其自主决定权的义务之间也会产生进一步的冲突。此外,各种尽职履行的医疗活动与我们自身的社会需求和利益背道而驰;最后但同样重要的是,人类的不完美影响了我们的一些决策,使其价值存在明显瑕疵。总之,医生必须不断承受相互矛盾的替代方案带来的负担,并且在每一个治疗步骤中都面临着犯错的陷阱。他们唯一的指导方针是直觉和职业奉献精神。