Clinical Physician's Medical Consequence Theory in Medical Ethics

(A) Consequence theory

Consequence theory is an important theory of ethics, also known as teleology or effect theory, which takes the consequences of moral behavior as the ultimate basis for determining moral norms. It believes that the purpose of determining moral norms is to adjust people's interests, and morality regulates the interest relationship between people, so that moral behavior can achieve good behavior results. According to the difference of moral utility subject (moral beneficial subject), the consequence theory mainly includes egoism, utilitarianism and public welfare theory.

Egoism is the consequence theory of determining moral norms according to whether the behavior takes its own interests as its direct purpose. Egoism can be divided into extreme egoism and reasonable egoism. The former believes that the established moral norms must be directly conducive to the realization of their own interests, regardless of the interests of others, even if it hurts the interests of others. For example, Steiner of Germany put forward the extreme egoism theory of "I am everything". The latter is to pursue personal interests without harming the interests of others. "Subjectively for yourself and objectively for everyone." Such as French helvetius, German Feuerbach and Russian Chernyshevski all hold this view.

Utilitarianism is the consequence theory of determining moral norms according to whether the behavior takes the interests of stakeholders as the direct purpose. The principle of utilitarianism is "the happiness of the majority". Utilitarianism holds that a certain moral standard must be directly beneficial to the happiness of most people. For example, Hume, Adam Smith, Bentham and Mill in Britain all hold this view.

Public welfare theory is the consequence theory of determining moral norms according to whether the behavior takes social public interests as the direct purpose. With the continuous socialization of human beings, different groups, countries and even the whole world have the same long-term interests, which are closely related to everyone's interests. The concept of public welfare has existed since ancient times. Nowadays, people in the world are facing a series of practical problems, such as environmental pollution, resource shortage, population explosion and the gap between the rich and the poor, which makes people's sense of public welfare unprecedentedly strong. According to the theory of public welfare, the determined moral norms must be directly beneficial to the common interests of mankind.

(B) the theory of medical consequences

The theory of medical consequences is an important theory of medical ethics, which takes the consequences of medical moral behavior as the ultimate basis for determining medical moral norms. It is believed that the purpose of determining medical ethics is to adjust people's interests, and medical ethics adjusts the interest relationship between people, so that medical ethics can achieve good behavior results.

The theory of medical consequences is also one of the ancient and eternal medical ethics theories, and it is the implementation of the theory of consequences in the medical field. The earliest theory of medical consequences can be traced back to Hippocrates' medical ethics. His principles of "benefiting patients" and "not hurting patients" have the ultimate goal of medical ethics and become the starting point of medical behavior and medical ethics. Since then, a large number of medical moral norms (medical moral obligations) in medicine, such as confidentiality, kindness, loyalty to medical skills, kindness and modesty, seriousness and pragmatism, are based on two basic principles revealed by Hirsch, which embodies the ultimate goal of medical morality.

With the socialization of medicine, especially the birth of medical institutions, the doctor-patient relationship has changed from a single doctor to a single patient to many medical personnel (not just doctors) to many clients (not just patients themselves). The medical interface needs to consider the interests of customers and other "stakeholders" and needs the guidance of utilitarianism. For example, contemporary bioethics puts forward the principle of justice, which requires that when treating patients (in order to meet the interests of patients), we should consider whether other patients need treatment more.

Today, medicine has become a public welfare undertaking. All mankind, different nationalities, countries and groups have their own long-term interests, and they also need to consider the guidance of social welfare and public welfare theory. 1973, a seminar on protecting health and changing values was held in the United States. At the meeting, Professor Johnson of the University of California School of Medicine and Hull Negus, director of the Institute of Human Reproduction and Bioethics of Georgetown University, put forward the theory of public welfare. With the deepening of people's understanding that reproductive technology, genetic technology and other medical high-tech will affect the long-term health interests of mankind and future generations, the theory of public welfare has attracted more and more attention and admiration.

Second, the benefits of the theory of medical consequences

(a) the interests of customers

1, the interests of patients

The clients of medicine are generally patients, but with the development of medical science and medical practice, many healthy people have also become clients of the medical profession.

The "patient benefits" here mainly refer to the health benefits such as eliminating patients' pain and treating diseases, as well as the material benefits related to patients.

2. Interests of stakeholders

With the continuous socialization of medicine, the medical interface faces not only one patient, but also other patients; Not only the patient himself, but also the relatives of the patient. The interest relationship faced by the medical industry has become complicated. When the theory of medical consequences requires the determination of medical ethics, not only the health and material interests of patients should be put in the first place, but also the interests of other clients and even relatives of patients should be considered.

3. Medical public welfare

Public welfare in medicine is the interest of groups and society, and it is the long-term interest of mankind. With the development of medical science and the emergence of new medical model, medicine has developed into a social undertaking, and medical activities are closely related to the interests of a certain group, the whole society and even all mankind, not only to the current interests, but also to the long-term interests; It concerns not only the interests of contemporary people, but also the interests of future generations. The public welfare fields in the medical field collected by the examination website mainly include: population control, population quality improvement, environmental protection, resource protection, gender ratio coordination, and maintaining the continuity and purity of human species.

(B) the interests of the medical industry

Traditional medical ethics pays attention to safeguarding the interests of patients and avoids the interests of the medical profession. In fact, the doctor-patient relationship is the basic ethical relationship of medical ethics, and the most basic mission of medical ethics is to rationally adjust the interest relationship between the medical community and the clients. The interests of the medical profession are obviously an important part of the theory of medical consequences.

When medical scientific research and medical and health practice become the profession of medical personnel, the interests of medical profession are an unavoidable problem, and medical profession becomes the condition for medical researchers and medical and health workers to survive. Under the condition of market economy, although China's health service is a social public welfare service that the government implements certain welfare policies, medical and health services must be market-oriented and adapt to the development needs of market economy. Medical and health units are also market players, and the services they provide also participate in social exchanges. The market mechanism also plays a role in the allocation of social resources in this field and between societies. It's just that these market players have been treated specially by the state and society, and these resource allocations have been more specially intervened by the state and society.

The interests of the medical profession must be safeguarded, which is the responsibility of the "social" subject of medical ethics. Today, the development of medical ethics has broken through the stage of medical self-discipline, and the main body of medical ethics is the whole society. From the perspective of social moral governance, we should not only safeguard the individual and overall interests of the clients, the current and long-term interests, but also safeguard the interests of the medical industry. Only in this way can we safeguard the interests of patients, ensure the normal development of the medical industry, and better safeguard the interests of patients.