Goić A
Unidad de Planificación de la Educación Médica (UPEM), Facultad de Medicina, Universidad de Chile, Santiago de Chile.
Rev Med Chil. 1996 Jul;124(7):873-9.
For the public opinion, medical strikes are a controversial issue; physician's ethical judgments are also different. The present article analyses the requisites to consider legitimate a strike and, based on these, the ethical duties of physicians; the features of medical unionism; the ethical duties of authority; the manipulation of ill people by the strike and the social factors that may cause these conflicts. In a medical strike, universal ethical values based on the Hyppocratic oath and promoted by the profession, are endangered. This article concludes that a medical strike may be explainable due to different reasons, but it is not ethically justifiable beyond any doubt. The health profession that is not prepared to give up strikes as gremial pressure tool, should not choose a profession that takes care of the ill. The best way to avoid medical strike is to prevent them: the society and the authority have the ethical obligation to create work conditions that elude conflicts. To settle disputes between physicians and health institutions, the creation of a permanent arbitral instance agreed by physicians and the authority, i.e. a high level committee integrated by respected individuals and physicians, could be necessary. This committee should send forth veredicts that would be obeyed by the contending parties.
对于公众舆论而言，医疗罢工是一个有争议的问题；医生的伦理判断也不尽相同。本文分析了认定罢工合法所需的条件，并基于此探讨了医生的伦理责任、医疗工会主义的特点、当局的伦理责任、罢工对病人的影响以及可能引发这些冲突的社会因素。在医疗罢工中，基于希波克拉底誓言并由该职业所倡导的普遍伦理价值观受到了威胁。本文的结论是，医疗罢工可能因不同原因而具有可解释性，但在伦理上绝不是无可争议的正当行为。如果医疗行业不准备放弃将罢工作为行业压力工具，那就不应选择从事照顾病人的职业。避免医疗罢工的最佳方法是预防罢工：社会和当局有伦理义务创造能够避免冲突的工作条件。为了解决医生与医疗机构之间的争端，可能有必要设立一个由医生和当局共同认可的常设仲裁机构，即一个由德高望重的人士和医生组成的高级别委员会。该委员会应作出双方都必须遵守的裁决。
