Winau R
Institut für Geschichte der Medizin, Freie Universität Berlin, Germany.
Forensic Sci Int. 1994 Dec 16;69(3):285-9. doi: 10.1016/0379-0738(94)90393-x.
For the last number of years, when ethical problems were discussed in Germany in public, the hippocratic oath was quoted as the valid norm for medical ethics. Although no physician swears this oath in Germany, it is necessary to know its contents, its origin and its role in the history of medicine. And it is necessary to ask some questions: What are the ethical claims of the hippocratic oath? Does it really originate from Hippocrates? How and why did the hippocratic oath become the 'Magna Carta' of behaviour for physicians? Do specific medical ethics exist over time? Do specific medical ethics exist in general? And if it exists, can it be normative ethics? A short survey of the multiple dependences of medical situations shows that ethics in medicine must undertake a new beginning. It cannot be normative ethics, it cannot be situation ethics, it must be differential ethics. It has to respect rules and declarations, but it has also to compare the benefits and risks. In the center of such ethics stands the responsibility of the physician. To assume this responsibility, the physician needs knowledge, the ability to make decisions and a conscience.
在过去的若干年里，每当德国公开讨论伦理问题时，希波克拉底誓言都会被引述为医学伦理的有效规范。尽管在德国没有医生宣誓遵守这一誓言，但了解其内容、起源及其在医学史上的作用是很有必要的。而且有必要提出一些问题：希波克拉底誓言的伦理主张是什么？它真的源自希波克拉底吗？希波克拉底誓言是如何以及为何成为医生行为的“大宪章”的？特定的医学伦理会随时间而存在吗？一般来说特定的医学伦理存在吗？如果存在，它能成为规范伦理吗？对医疗情形的多重依存关系进行的简短考察表明，医学伦理必须开启新的开端。它不能是规范伦理，不能是情境伦理，而必须是差异伦理。它必须尊重规则和声明，但也必须比较益处和风险。这种伦理的核心是医生的责任。为承担这一责任，医生需要知识、决策能力和良知。
