Guo Z
Political Department, Fourth Military Medical University, Xian, Peoples' Republic of China.
J Med Ethics. 1995 Aug;21(4):239-46. doi: 10.1136/jme.21.4.239.
The Confucian culture, rich in its contents and great in its significance, exerted on the thinking, culture and political life of ancient China immense influences, unparalleled by any other school of thought or culture. Confucian theories on morality and ethics, with 'goodness' as the core and 'rites' as the norm, served as the 'key notes' of the traditional medical ethics of China. The viewpoints of Confucianism on benevolence and material interests, on good and evil, on kindheartedness, and on character cultivation were all inherited by the medical workers and thus became prominent in Chinese traditional medical ethics. Hence, it is clear that the medical profession and Confucianism have long shared common goals in terms of ethics. Influenced by the excellent Confucian thinking and culture, a rather highly-developed system of Chinese traditional medical ethics emerged with a well-defined basic content, and the system has been followed and amended by medical professionals of all generations throughout Chinese history. This system, just to mention briefly, contains concepts such as the need: to attach great importance to the value of life; to do one's best to rescue the dying and to heal the wounded; to show concern to those who suffer from diseases; to practise medicine with honesty; to study medical skills painstakingly; to oppose a careless style of work; to comfort oneself in a dignified manner; to respect local customs and to be polite; to treat patients, noble or humble, equally, and to respect the academic achievements of others, etc. Of course, at the same time, Confucian culture has its own historical and class limitations, which exerted negative influences on traditional medical ethics. Now, if we are to keep up with the development of modern medicine, a serious topic must be addressed. That is how to retain the essence of our traditional medical ethics so as to maintain historic continuity and yet, at the same time, add on the new contents of medical ethics so as to incorporate modern features into our system. Therefore, when trying to reform medical practice in China, we are faced with the urgent need to inherit and promulgate the essence of Confucian ethics--discarding its obsolete concepts--while at the same time building up the new medical ethics that can meet the requirements of the outside world and the future.
儒家文化内涵丰富、意义重大,对中国古代的思想、文化及政治生活产生了巨大影响,其他任何思想流派或文化都无法与之相比。儒家以“仁”为核心、以“礼”为规范的道德伦理学说,成为中国传统医学伦理的“基调”。儒家关于仁爱与功利、善恶、仁慈及品德修养的观点,均为医家所传承,从而在中国传统医学伦理中得以彰显。由此可见,在伦理方面,医学与儒家长期以来有着共同的目标。受儒家优秀思想文化的影响,中国传统医学伦理形成了一个相当完备的体系,其基本内容明确,且为历代医家所遵循和完善。简要而言,这个体系包含诸多理念,如高度重视生命价值;竭尽全力救死扶伤;关爱病患;诚信行医;刻苦钻研医术;反对粗疏作风;端庄自处;尊重地方习俗、礼貌待人;不论贵贱平等对待患者;尊重他人学术成果等。当然,与此同时,儒家文化也有其自身的历史和阶级局限性,对传统医学伦理产生了负面影响。如今,若要跟上现代医学的发展,就必须面对一个严肃的课题。即如何在保留传统医学伦理精华以保持历史延续性的同时,增添医学伦理的新内容,使我们的体系融入现代特色。因此,在中国进行医疗改革时,我们迫切需要继承和弘扬儒家伦理的精华——摒弃其陈旧观念——同时构建能够满足外界及未来需求的新医学伦理。