Achslogh J
Acta Chir Belg. 1983;Suppl:90-5.
Through the evolution of medicine, its recent progress, in particular, in the geriatric surgery, new ethical problems arise. It is the surgeon's task to study these problems and, bearing in mind the moral and medical factors, to suggest lines of conduct. On examining the results of this surgery, it is noticeable that one cannot speak of therapeutic eagerness. On the contrary, not to resort to surgery could be assimilated with non-assistance of a person in need. Through its subjectiveness, the notion of quality of life that can be ascertained after surgery, is difficult to describe. It is for the surgeon to see that his own value judgment is not given priority. In this respect, the relation patient-surgeon is most important. The results of geriatric surgery must be critically studied, without forgetting the traditional criteria of duration of life modulated with the supplementary notion of mortality due to the senescence pathology. The scientific study of the results involve post mortem verifications, which are ethically considered as quite normal. The medical body is conscious of the fact that many of the medical progress and in particular those obtained in geriatric surgery, create economical problems. Nevertheless, our task is to push the progress of medicine as far as possible in spite of the economical pressure which it represents. Should the economists and politicians feel these costs are exaggerated, it is they who should inform the population. But, doctors have also the right to say that these economical measures are not justified, and this in relation with the objective results of the type presented today.
随着医学的发展,尤其是其近期在老年外科领域的进展,新的伦理问题出现了。研究这些问题并在考虑道德和医学因素的情况下提出行为准则是外科医生的任务。在审视这种外科手术的结果时,可以注意到不能称之为治疗的急切性。相反,不采取手术可能会被等同于对有需要的人的不救助。由于手术后可确定的生活质量概念具有主观性,所以难以描述。外科医生要确保自己的价值判断不被置于优先地位。在这方面,患者与外科医生的关系最为重要。必须对老年外科手术的结果进行批判性研究,同时不能忘记传统的生命时长标准,并结合衰老病理导致的死亡率这一补充概念。对结果的科学研究涉及尸检验证,从伦理角度看这被视为相当正常。医学界意识到许多医学进展,尤其是在老年外科取得的进展会带来经济问题。然而,尽管医学进展带来经济压力,我们的任务仍是尽可能推动医学进步。如果经济学家和政治家觉得这些成本过高,应该由他们向民众说明。但是,医生也有权说这些经济措施不合理,而且这与当今所呈现的那种客观结果有关。