醫學倫理與法律4
視病猶親與視醫如親
陳榮基
很多醫院都標榜「視病猶親」,以之勉勵及要求醫院全體同仁,發揮愛心,對待所有病人及家屬,皆如至親之想. 醫界先賢孫思邈（581-673AD）在其「千金方『論太醫精誠』」中要求「凡太醫治病，必當安神定志，無欲無求，先發大慈惻隱之心，誓願普救含靈之苦。若有疾厄來求救者，不得問其貴賤、貧富、長幼、妍蚩、怨親善友、華夷、愚智，普同一等，皆如至親之想。…..見彼苦惱，若己有之，身心悽凔，勿避險戲、晝夜、寒暑、飢渴、疲勞，一心赴救。」就是這種「視病猶親」的最好註解.
西方醫聖希波克拉底(460?-377? BC)的誓約要求: 「無論在何處我都以協助病人為目的,禁犯任何故意的傷害與過失」, 「我盡我之能力及判斷力以醫術去治病,決不可以存絲毫傷害和錯誤的心理」. 現代西方醫學倫理的四大原則就是「利益病患，切勿傷害，病人自主、秉持公義」（Beachaump,TL, Childress, JF. 1994) 。古今中外,做人的道理，以及對醫師與病人間的互動關係的要求，都是一樣的。
世界醫學會的日內瓦宣言: 「我嚴肅地宣誓,我將以我的生命奉獻為人類服務.」「我將以良知和尊嚴去執行醫學專業.」「病人的健康是我的第一考量.」國際醫學倫理法規要求: 「醫師應尊重病人...保持病人的信任.」「醫師必先考量病人的利益.」
2007年底,本人重遊河內,參訪數家醫院并拜會越南衛生部及河內衛生局,數次在牆上看到很顯目的匾額上書越文”LUONG Y NHU TU MAU”,請教老友越德醫院阮德正醫師,才知是「良醫如慈母」(良醫如母)的意思.看到他們對醫德的重視,不勝感佩.又在牆上看到十條”Y DUC”(醫德)的規範,特請阮醫師譯解,與我醫界同仁人分享:1.醫德是一種藝術(醫學是科學也是藝術);2.不要引起病人的困擾(切勿傷害);3.對待病人不分貧富貴賤(公平、公義原則);4.特別關心極端貧窮的病人(照顧弱勢);5.不因利益而損及醫者的尊嚴(維護醫界的榮譽);6.追求至高的靈性;7.用藥如帶兵應小心謹慎(利益病患及切勿傷害原則);8.犯錯應知悔改(知過能改);9.不可放棄危急病人;10.保持誠實及奉獻心.
越南醫界在醫院內到處揭示:「良醫如母」,以及「醫德」的規範,我們在向醫師宣導「視病猶親」的同時,是否也可向病人宣導「視醫如親」的理念希望做到「醫病一家」或「醫病一家親」, 病人能永遠保持對醫師的信任,醫師也能保持慈母般恆久不衰的愛心,化解醫療糾紛的壓力,讓醫師不會因為醫療糾紛的困擾而氣餒.醫師都能「視病猶親」,病人也能「視醫如親」,醫病關係和樂融融.(本文刊登於台灣醫界2008年2月號; 51(2): 85)
2008年2月3日 星期日
視病猶親與視醫如親
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2 則留言 :
Dear professor Chen,
Sincere congratulations to the debut of your blog. I have just taken a quick look and found it very interresting, informative, inspirational and touching the most senstivie issues of life, rarely seen anywhere on the media, papaerwise or on the Internet. It deserves extensive attention from medical professionals, phylosophers and religious leaders, and of course, general public who takes serious altitude towards life. In one word, I have seen the earliest sign of a light just on the horizon. Given time it will grow quickly into a brilliant star in dark sky with little room of discussion of life in such a deep and scientific magnitude. Congratulations again not only for you in person, but also, even more meaningfully, for a new academic and phylosphical forum coming along. I will do my best to spread the news and the site of the blog so more people would have a chance learning and thinking of the issues brought up in your loudspeaker. I will visit it from time to time to keep up with your new thouhts conveyed in your new papers and discussions. You are welcome to send me a notice any time if there is a new publication in the blog.
Zhong Y. Liu, M.D.
2008/02/06(Chinese New Year's eve)
I went through your blog and was very much impressed by your writings. You depicted in details your life story, your philosophy and religious belief. You are a superb writer, a devoted physician and great teacher. Congratulations. May I suggest that you publish this as a auto-bibliography?
K.M. Chen, M.D.
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