医学伦理决策中的道德原则冲突

医学伦理决策中的道德原则冲突 安乐死中关于救死扶伤与减轻痛苦之间的矛盾其实反映了现代 医疗实践当中伦理决策的困境,即现代医疗体系中伦理决策原则相互 之间的冲突性。 科学技术的进步激化了医学伦理学基本原则中包含的一对固有 矛盾。作为医学伦理学基础的希波克拉底誓言,一方面要求医生解除 病人的痛苦,另一方面又要求延长病人的生命。以前只要一个人无法 进食,生命就难以维持,而呼吸、心跳停止,就算死亡;残疾人很难 终其天年。由于一些治疗措施的进步,许多不治之症的结局可以变得 相当拖沓。这样一来,病人临终前的痛苦也延长了,这种痛苦不可能 在死亡到来前解除。不少疾病终末期的病人,由于不能忍受病痛的折磨,哀求医生结束他的生命,当他们的要求得不到满足时,他们有时 就杀死自己。但由于不谙生理解剖,在结束自己的生命时,他们往往 不得不忍受多余的痛苦。于是,有关安乐死的案例和讨论不断出现。 在现代医疗体系中得到较多共识的是以下四个原则:尊重自主,即要求尊重自主人的决策能力的原则;不伤害,即要求避免引起对他 人伤害的原则;行善,即要求阻止伤害、促进利益和权衡利益与风险、 代价的原则;公正,即要求公平地分配利益、风险与代价的原则。此 四项原则是医疗实践中应遵循的基本原则,其根本价值目标是一致的,即维护患者利益,但每一具体原则又有其各自的伦理依据和对象性要求,从而在具体医疗情境之中,它们之间往往会发生冲突、出现矛盾, 即当我们从不同的伦理决策原则出发,会对同样一件事情得出不同结论。我们分别从尊重自主原则与不伤害原则出发,就会形成对待安乐 死的两种不同态度。 Medical ethics and moral principles of conflicts of Decision Euthanasia contradictions between saving lives and alleviate the suffering of about actually reflects the predicament of modern medical practice, ethical decision-making, conflict of modern health care system that is the principle of ethical decision-making between each other. The intensification of scientific and technological progress of a contradiction inherent in the basic principles of medical ethics included. As the basis of the Hippocratic Oath of Medical Ethics, on the one hand ask the doctor to relieve the patient's pain, on the other hand they requested an extension of the patient's life. Before, when a person can not eat, life is difficult to maintain, and breathing, cardiac arrest, even death; people with disabilities is difficult to the end of their natural life span. Due to advances in a number of therapeutic measures, many incurable outcome can become quite procrastination. Thus, the agony of dying patients also extended, the pain can not be lifted before the coming of death. Many patients with end-stage disease, the inability to tolerate the pain of torture, begged doctors to end his life, when their demands are not met, they sometimes kill themselves. But because not fluent in anatomy and physiology, at the end of their lives, they often have to endure unnecessary suffering. Thus, cases and discussion of euthanasia emerging. Get more consensus in the modern health care system in the following four principles: respect for autonomy, which requires respect for the principle of independent decision-making ability of people; it does not hurt, that principle requires avoid harm to others; and do good, which requires to prevent injury, the principle of promoting the interests and to weigh the benefits and risks, cost; fair, which requires the equitable distribution of the benefits, risks and cost principles. This four principles are fundamental principles of medical practice should be followed, the fundamental value of the target is the same, namely, to maintain the interests of patients, but each has its own specific principles and objects based on ethical requirements, resulting in the specific context of health , often conflicts occur between them, there is a conflict, that is, when we start from a different ethical decision-making principle, the same thing will come to different conclusions. We are departing from the principle of do no harm and to respect the principle of autonomy, it will form two different attitudes to treat euthanasia.