[Medical performance: ethical and conceptual issues].
Following an introductory criticism of the Hippocratic Oath and a health-maximizing principle as ethical basis for health care, an evaluation of medical performance is presented according to 3 underlying concepts, namely 1) the act of performing medical procedures itself, 2) effectiveness and 3) efficiency. A discussion of these issues shows that statements on increasing effectiveness and efficiency only make sense if a prior clear definition of the aims of medicine can be presumed. Moreover, the achievement of an increase in medical efficiency requires quantification of the aims of medicine, whereby it is not self evident that these are quantifiable. Certain ethically relevant principles, such as justice and self determination, may remain unaffected by such considerations, however. Consequently, none of the 3 discussed concepts to measure medical performance can be regarded as a sufficient basis for a comprehensive ethical evaluation of a health care system.
Widder
J
J
Institut für Geschichte der Medizin, Universität Wien.
D000818:Animals; D001317:Austria; D004992:Ethics, Medical; D006168:Guinea Pigs; D006801:Humans; D017063:Outcome Assessment, Health Care; D011785:Quality Assurance, Health Care