希波克拉底誓詞
维基百科，自由的百科全书
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本條目正在從en:Hippocratic Oath翻譯成中文。 歡迎您積極參與翻譯與修訂，目前已翻譯20%。 |
希波克拉底誓詞是西方医生傳統上行醫前的誓言。在這份誓詞中，列出了一些特定的倫理上的規範。
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[编辑] Traditional text
医神阿波罗，埃斯克雷彼斯及天地诸神为证，鄙人敬谨宣誓，愿以自身能判断力所及，遵守此约。凡授我艺者敬之如父母，作为终身同世伴侣，彼有急需我接济之。视彼儿女，犹我弟兄，如欲受业，当免费并无条件传授之。凡我所知无论口授书传俱传之吾子，吾师之子及发誓遵守此约之生徒，此外不传与他人。
我愿尽余之能力与判断力所及，遵守为病家谋利益之信条，并检束一切堕落及害人行为，我不得将危害药品给与他人，并不作此项之指导，虽然人请求亦必不与之。尤不为妇人施墮胎手术。我愿以此纯洁与神圣之精神终身执行我职务。凡患结石者，我不施手术，此则有待于专家为之。
无论至于何处，遇男或女，贵人及奴婢，我之唯一目的，为病家谋幸福，并检点吾身，不做各种害人及恶劣行为，尤不做诱奸之事。凡我所见所闻，无论有无业务关系，我认为应守秘密者，我愿保守秘密。倘使我严守上述誓言时，请求神只让我生命与医术能得无上光荣，我苟违誓，天地鬼神共殛之。
[编辑] Modern relevance
Several parts of the Oath have been removed or re-worded over the years in various countries, schools, and societies but the Oath still remains one of the few elements of medicine that have remained unchanged. Most schools administer some form of oath, but the great majority no longer use this ancient version, which praises pagan gods, advocates teaching of men but not women, and forbids cutting, abortion, and euthanasia.1 Also missing from the ancient Oath and many modern versions are complex, new ethical landmines such as dealing with HMO's, living wills, whether morning-after pills are technically closer to prophylactics or an abortion (they are different from RU-486), experiments on humans who give informed consent, or genetic research. Some doctors prefer to drop all pretenses of swearing an oath or forcing others to do so, since medical boards and courtrooms are the real forces where unethical conduct is judged today. Following is a listing of the specific promises and a modern perspective:
- To support my teacher if necessary. Professional courtesy (not charging families of physicians for one's services) is perhaps the last trace of this item and has largely been abandoned.
- To teach medicine to the sons of my teacher. In the past, medical schools would give preferential consideration to the children of physicians. This too has largely disappeared.
- To practice and prescribe to the best of my ability for the good of my patients, and to try to avoid harming them. This beneficial intention is the purpose of the physician. However, this item is still invoked in discussions of euthanasia.
- To never deliberately do harm to anyone for anyone else's interest. Physician organizations in the U.S. and most other countries have strongly denounced physician participation in legal executions.
- To never attempt to induce an abortion. The wide availability of abortions in much of the world suggests that many physicians no longer feel bound by this.
- To avoid violating the morals of my community. Many licensing agencies will revoke a physician's license for offending the morals of the community ("moral turpitude").
- To avoid attempting to do things that other specialists can do better. The "stones" referred to are kidney stones or bladder stones, removal of which was judged too difficult for general practitioners, and therefore was left for specialists. It is interesting how early the value of specialization was recognized. The range of knowledge and skills needed for the range of human problems has always made it impossible for any single physician to maintain expertise in all areas.
- To keep the good of the patient as the highest priority. There may be other conflicting "good purposes," such as community welfare, conserving economic resources, supporting the criminal justice system, or simply making money for the physician or his employer that provide recurring challenges to physicians.
- To avoid sexual relationships or other inappropriate entanglements with patients and families. The value of avoiding conflicts of interest has never been questioned.
- To keep confidential what I learn about my patients. Confidentiality continues to be valued and protected, but governments and third-party payors have occasionally encroached upon it.
[编辑] Modern alternatives
In the 1970s cultural and social forces induced many American medical schools to abandon the Hippocratic Oath as part of graduation ceremonies, usually substituting a version modified to something considered more politically up to date, or an alternate pledge like the Oath or Prayer of Maimonides.
The Hippocratic Oath has been updated by the Declaration of Geneva, q.v. In the United Kingdom, the General Medical Council provides clear modern guidance in the form of its 'duties of a doctor' and 'Good Medical Practice' statements.
