欺騙第三者的倫理考量

Is It Ethical for Physician to Deceive the Third Party on Behalf of the Patient's Interest?

陳振業(Chan-Ip Chan)

《北市醫學雜誌》 5卷2期 (2008/04) Pp. 185-192

https://doi.org/10.6200/TCMJ.2008.5.2.02

摘要

臨床工作中醫師無可避免會遇到道德兩難(moral dilemma)，其中一個是病患的不當請求(inappropriate request)，病患時常為了個人利益要求醫師幫忙欺騙保險單位、政府機構或私人企業等第三者(the third party)。本文將檢視四個常被用來支持欺騙第三者的理由，它們分別是：應允比拒絕病患容易、矯正不正義的醫療體系、促進病患的利益及加深醫病關係之信任，並說明為何這些理由皆無法通過道德考驗，再透過反省「醫療之目的與界限」此一基本問題，指出行善義務並不要求醫師必須幫助病患追求所有的個人利益。

關鍵字

醫學倫理 ； 欺騙 ； 第三者

並列摘要

Physicians inevitably face various moral dilemmas in clinical situations. One of them is the inappropriate request from the patient. Patients often ask their physicians to help them deceive the third parties, including insurance units, governmental authorities and private companies, for personal benefit. This paper discusses whether four reasons which are frequently cited in the literature are morally acceptable. These include the following: less difficulty in agreeing to the patient request than refusing, rectifying current unjust health care regulation, serving the benefit of the patient, and promoting trust inherent in the doctor-patient relationship. By considering the purpose and scope of medicine, it is argued that the personal benefit and interests of the patients are not always the morally appropriate objectives which should be pursued by physicians.

並列關鍵字

medical ethics ； deception ； third party