論病情告知的倫理困境

The Dilemma of Truth - Telling

病情告知在當今重視醫療人權、病人安全但醫療糾紛不斷的醫療環境中更凸顯其面臨之倫理困境。本文就西方規範倫理學中彌爾的效益主義和康德的道德哲學以及孔孟儒家倫理學對行爲的道德法則是否適用於病情告知作一簡要之剖析。作者認爲病情告知的倫理困境在於是否眞有一放諸四海皆應奉行的道德準則。而結論是醫師需因人、地、時、事之不同對病人和家屬做適當的病情告知。然而這並不意味著醫師僅憑臨床經 驗即可達成此一重任，相反地，醫師應熟練各種倫理學理論，以豐富其行爲之動力。

Informed consent or disclosure plays a prominent role in modern high-tech medical environment which are required a higher standard of quality care and patient's safety in health service sector, so the dilemma of truth-telling becoming a Sisyphus's task for today's physicians. The author analyzes the pros and cons of three moral theories, that is, Utilitarianism of John Stuart Mill, Groundwork of the Metaphysic of Moral of Immanuel Kant and Analects of Confucian and Mencius, and argues that whether if there is a universal moral principle can be apply in the setting of truth-telling. The author concludes that the accountability of a physician's truth-telling may securely rely on a mutual opened-minded dialogue between doctors and patients.