Thomasma D C
Ann Intern Med. 1983 Feb;98(2):243-8. doi: 10.7326/0003-4819-98-2-243.
Medical paternalism lies at the heart of traditional medicine. In an effort to counteract the effects of this paternalism, medical ethicists and physicians have proposed a model of patient autonomy for the physician-patient relationship. However, neither paternalism or autonomy are adequate characterizations of the physician-patient relationship. Paternalism does not respect the rights of adults to self-determination, and autonomy does not respect the principle of beneficence that leads physicians to argue that acting on behalf of others is essential to their craft. A model of physician conscience is proposed that summarizes the best features of both models--paternalism and autonomy.
医学家长主义是传统医学的核心所在。为了抵消这种家长主义的影响，医学伦理学家和医生提出了一种医患关系中的患者自主模式。然而，家长主义和自主都不足以充分描述医患关系。家长主义不尊重成年人的自决权，而自主则不尊重善举原则，正是该原则使医生认为代表他人行事对其职业至关重要。本文提出了一种医生良知模式，该模式总结了家长主义和自主这两种模式的最佳特征。
