IV. Discourse Structure: Choose the best answer. 5% (各 1 分)
Medical ethics is a system of moral principles that apply values and judgments to the
practice of medicine. As a scholarly discipline, it encompasses the practical application in
clinical settings as well as work on its history, philosophy, theology, and sociology. ___31___
The first code of medical ethics was published in the 5
th century. Thomas Percival crafted the
first modern code of medical ethics in 1794 and expanded it in 1803, in which the expression
“medical ethics” was coined. In the 20th century, this discipline went through a dramatic shift
and largely reconfigured itself into bioethics.
A common framework used in the analysis of medical ethics is the “four principles”
approach postulated by T. Beauchamp and J. Childress in their textbook Principles of
biomedical ethics. ___32___The first principle is respect for autonomy, which means the
patient has the right to refuse or choose their treatment. Beneficence, the second principle,
emphasizes that a practitioner should act in the best interest of the patient. The third principle,
non-maleficence, means that doing no harm to patients is more important than doing them good.
___33___ These principles do not give answers as to how to handle a particular situation, but
provide a useful framework for understanding conflicts.
When moral values are in conflict, the result may be an ethical dilemma or crisis.
Sometimes, no good solution to a dilemma in medical ethics exists, and occasionally, the values
of the medical community (i.e., the hospital and its staff) conflict with those of the individual
patient, family, or larger non-medical community. Conflicts can also arise between health care
providers, or among family members. ___34___ Many so-called “ethical conflicts” in medical
ethics are actually traceable back to a lack of communication. Communication breakdowns
between patients and their health care team, between family members, or between members of
the medical community, can all lead to disagreements and strong feelings. ___35___
【題組】32
(A) These breakdowns should be mended, and many apparently insurmountable “ethics”
problems can be solved with open lines of communication.
(B) Confidentially is commonly applied to conversation between doctors and patients, and is commonly known as patient-physician privilege.
(C) It recognizes four basic moral principles, judged and weighed against each other, with
attention given to the scope of their application.
(D) The last one, justice, concerns fairness and equality, that is, the distribution of scarce health
resources and the decision of who gets what treatment.
(E) Historically, Western medical ethics may be traced to guidelines on the duty of physicians
in antiquity, such as the Hippocratic Oath and early Christian teachings.
(AB) For example, the principles of autonomy and beneficence clash when a patient does not
want a treatment because of religious or cultural views.
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