精神医学中的伦理学.ppt

chapter 25 ethics in psychiatry 精神医学中的伦理学 chen-min jining medical university lstudy medical moral l1803: thomas percival （托马斯帕茨瓦尔） medical ethics lmedical ethics l医学伦理学是运用一般伦理学的道德原则， 解决医疗实践和医学科学发展中人们相互之 间、医学团体与社会之间关系而形成的一门 科学 medical ethics moral and ethics nmoral道德 nethics伦理 moral道德 nthe semantic distinction between morals and ethics generally refers to those values a society accepts as universal principles contrasted with the principles that are relative to a particular context or era. general moral principles govern the behavior of all citizens and are deemed both universal and immutable. ethics伦理 nthe term “ethics“ is usually reserved for the moral principles restricted to certain groups, such as those in a profession. that role-bound morality can consist of internal or external standards of ethical conduct. for the psychiatric profession, the principles of medical ethics with annotations especially for psychiatry , developed by the apa, is an example of an internal standard used by the professions major organization to regulate the behavior of its members. judicial, legislative, or executive bodies may impose external standards as well. core principles nautonomy自主 nnonmaleficence无害 nbeneficence仁慈 njustice公正 autonomy nthe principle of patient autonomy is of central importance and, conceptually, is in many ways coextensive with the legal concept of competence. a patient makes an autonomous choice by giving informed consent when that choice is (a) intentional, (b) free of undue outside influence, and (c) made with rational understanding. nonmaleficence nnonmaleficence is the duty of the psychiatrist to avoid either inflicting physical and emotional harm on the patient or increasing the risk of such harm. that principle is captured by primum non nocere, “first, do no harm.“ beneficence nthe principle of beneficence-to prevent or remove harm and promote well-being -as the primary driving principle of medical and psychiatric practice throughout history until the rise of consumerism and other factors in the late 1960s. justice nthe principle of justice in psychiatry does not operate in a vacuu