12月10日is Human Rights Day,在联合国大会通过《世界人权宣言》之日。为了纪念我们邀请Siroos Mirzaei的时刻,associate editor ofBMC International Health and Human Rights托马斯·温泽尔(ThomasWenzel)写了医生在维金宝搏体育护人权和危险方面所起的作用。

Physicians' involvement in human rights

作为医生,我们经常面临不同层次的道德和人权问题。Physicians can on the one hand be involved in the treatment of injuries related to war,但也有不同形式的侵犯人权。

萨尔瓦多·阿连德和切·格瓦拉被许多人视为英雄和社会改革者,即使在各自国家以外:Time magazine声称格瓦拉是20世纪最具影响力的人物之一。On the other hand there have been physicians like Mengele or Illig working actively and by their own free decision without regard for medical ethics in the German and Austrian National Socialist regime performing dubious"“研究”in the这种思想的精神.

医生也可以相信violate ethical standardsin a situation of""dual obligations",常见于监狱等情况。Dr.Wendy Orr,a former District Surgeon in Port Elizabeth in South Africa,wrote in her foreword to the British Medical Association's handbook on medicine and human rights,金宝搏体育about her work with detainees during the种族隔离制度.She describes how she became aware of the systematic abuse of detainees by the security forces and the silence and complicity of her medical colleagues.She recounts her growing moral disorientation as she realized she was expected to declare patients"fit"for corporal punishment.

Similar situations have recently been reported in asylum cases even in countries with better earlier human rights track records.美国医生和心理学家进一步参与了在关塔那摩折磨囚犯.


Human rights systems such as the universal prohibition of torture,outlined in联合国禁止酷刑公约are so fundamental that they cannot be suspended under any circumstances,they are"non-derogable",他们的违法行为可以而且必须受到调查和起诉。医生在这个过程中应该有一个特殊的积极作用。

The""Istanbul Protocol"得到联合国的平等支持,and the World Medical Association,is an interdisciplinary standard that guides physicians and legal professionals to collaborate in ethical and humanitarian standards,法医文件,报告,and investigation of所谓酷刑.它也有助于protection of survivorsapplying for asylum and for对犯罪者的起诉.

医生们可能会冒着维护这些法律和道德标准的风险。例如,it's beenreported在伊朗卡利扎克监狱目睹酷刑的人已经被杀害。

Courtesy of Vida Mehrannia

An Iranian physician,雅拉利,已经判处死刑in Iran because of allegations of spying for other countries.Up to now none of international protests and activities for his unconditional release have proven to lead to any significant positive development.

世界各地的卫生专业人员通过人权医师等组织参与维护人权的活动,使自己处于危险之中,无国界医生,the International Rehabilitation Council for Torture Survivors.如果没有这些组织的参与,世界危机地区的许多领域都会无法获得医疗服务.

The basic background of these activities are international standards and treaties along with ethical guidelines of the medical profession.The 1948 Universal Declaration of Human Rights already mentions健康是获得适当生活水平权利的一部分(艺术)25)。健康权在1966年再次被确认为人权。国际经济公约,Social and Cultural Rights.There are international instances of shortage of access to medical services,因为军事冲突或对一个国家的制裁。


最近,the practice of medicine has been subject to several transformations with unprecedented ethical challenges.One is the exponential increase in the sophistication and reach of medical technology.从基因操作到体外受精,,dataand机密性保护to the ethical risks enclosed at times in the巨大的进步in life-saving research and treatment,医学引发了巨大的社会意义上的道德挑战,医学本身,希波克拉底传统,have on their own not sufficiently responded to.Instead medicine has formed a fertile relationship with other disciplines,比如道德哲学和医法,to seek philosophically coherent and socially and legally对这些问题的可接受回答.

鉴于对医疗公正性最严重的威胁主要来自政府机构的干预,but also by excessively powerful commercial companies or political groups,医疗公正的一个关键方面是医生的能力speak out 金宝搏体育about health-related aspects of conflicts.

Where,例如,医生们看到了因国家对内乱的反应而受伤的病人,the documentation and reporting of those injuries is a core part of the medical response.If doctors cannot speak out,if they cannot draw attention to the health-related impacts of conflicts,他们冒着失去职业独立性的风险。

如果他们自愿违反基本标准,不应允许他们执业,医学协会和政府应注意采取一切必要措施确保这一原则,while on the other handsupporting human rights defenders.

Friedrich Schiller,也是个医生,反对任何对个人或政治自由的限制,并在以下诗句中强调,可以推断出医生的职责,即我们应将工作重点放在患者的需求上:


but do not be its creature.



not what they praise



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