以色列法院在制定医患关系中的作用。

IF 0.1 Q4 LAW MEDICINE AND LAW Pub Date : 2014-10-01
Limor Malul
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引用次数: 0

摘要

医患关系的本质在古希腊和古罗马,以及中世纪和现代文学中都有记载。早在希波克拉底的著作中,包括医患关系、患者对治疗的同意和生命终结问题在内的伦理困境就被提出和讨论过。随着时间的推移,在定义治疗环境时所考虑的不同值之间的动态变化已经发生。这种二元关系的本质已经从一种家长式的框架,赋予医生权力,强调病人的幸福,转变为一种关系框架,赋予病人权力,关注他的愿望和权利。医患关系的钟摆在每个时代都在不断调整,以符合当代社会价值观和由司法法庭和立法形成的规范。将医患关系问题视为深深植根于社会文化背景中的伦理困境,需要制定一个包含相关伦理原则和实施系统的理论框架,从而构成我们希望保护的价值观的意图宣言。目前的状况是,法律和立法安排将患者自主权置于其他重要的社会价值之上,这可以为更稳定、适当和富有成效的医患关系提供基础。本文希望批判性地考察法律是否以及以何种方式影响医患关系的特征,以及这种影响对医疗政策和实践的影响。鉴于这一领域的裁决缺乏一致性,通过立法采用道德准则的必要性以及法律体系建设性和系统地平衡医患关系中各种道德方法的必要性变得清晰起来。
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THE ROLE OF THE ISRAELI COURTS IN FORMULATING THE PHYSICIAN-PATIENT RELATIONSHIP.

The nature of physician-patient relationships has been documented in the ancient Greek and Roman, as well as in that of the Middle Ages and modern times' literature. Far back as in Hippocrates' writings, ethical dilemmas including those concerning patient-physician relationships, patient consent to treatment and end of life issues have been raised and discussed. Over time, changes have occurred in the dynamic between the diverse values that are taken into consideration when defining the therapeutic milieu. The nature of this dyad has have moved from a paternalistic framework empowering the physician and emphasizing the patient's wellbeing, to a relational framework that empowers the patient and is focused on his desires and rights. The pendulum of the physician-patient relationship is continually adjusted, in each era, in accordance with contemporary social values and by norms that have been shaped by judicial tribunals and legislation. Viewing the issue of physician-patient relationship as an ethical dilemma deeply rooted within social-cultural contexts demands the formulation of a theoretical framework incorporating the relevant ethical principles and a system of implementation that constitutes a declaration of intention concerning the values we thereby wish to protect. The current state of affairs in which legal and legislative arrangements prefer patient autonomy above other significant social values, could provide the foundation for a more stable, appropriate and fruitful physician-patient relationship. This article wishes to critically examine the questions of whether and, in what ways, the law influences the character of the physician-patient relationship and the implications of such influence for medical policy and practice. In light of the lack of consistency of rulings in this domain, the necessity of adopting ethical guidelines through legislation and need for the legal system to constructively and systematically balance the diverse ethical approaches regarding the physician-patient relationship, becomes clear.

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