对病人讲真话与保密的伦理思考

Ethical consideration about telling patients truth and keeping confidentiality

医生对病人讲真话是一种义务 ,也是尊重病人自主权的表现。但是 ,在中国的传统文化背景下 ,对某些病人保密而仅对家其家属讲真话 ,这与对病人讲真话发生了矛盾 ,也与病人的自主权发生了冲突。然而 ,这种矛盾和冲突 ,可以得到伦理的辩护 ,也可以得到中国现行法律的支持。尽管如此 ,也应该逐渐改变。

Telling patient the truth is the basic responsibility of a physician, and also a requirement of patients right of autonomy. But in actual clinical circumstances, physicians usually keep secret from patients about the bad news of their illness, but would tell the truth to patients family members,thereby there is a kind of conflict. If we can approach this issue from the principles of non-maleficience and beneficience, the conflict can be resolved, and can also get support from China current law system.