Jaromír Matějek

Conscience in Medical Practice

Conscience in medical practice

Structure: Casuistics I. and its commentary

Conscience in ethical codices

Conscience in psychology

Conscience in philosophy

Summary

Casuistic for reflection of students: II., III.

Casuistics I.

The doctor, her patient suffers in terminal stadium of the disease.

Patient is her good friend and asks for assistance with suicide.

The is against the assisted suicide both personally and professionally.

But there are frendship and natural sympathy.

Casuistics I.

Question:

Should not the doctor contrary to her personal and

professional conviction help her friend per assisted

suicide?

Conscience in medical codices

Code of Ethics of Czech Medical Chamber:

„The doctor could not be forced to those medical

practices or collaboration, which is against his/her

conscience“

Conscience in medical codices

Code of Ethics of Czech Medical Chamber:

The doctor should know the laws and regulation valid for his/her work, and abide them.

He/she need not feel obligated, when these laws and regulation acts againts medical ethics or human rights.

Conscience in medical codices

Code of Nurses: The nurse provides indicated cure, but denies to

participate in activities which is against ethics or her conscience.

Conscience in medical codices

Code of Nursers (CZ): The human conscience and love of people are the

only one and genuine sources of morality.

Conscience in psychology

Gestalt psychology differs between mood ant conscience rozlišuje mezi náladou a svědomím.

On one hand, conscience is built on mood and

emotions

On the other hand, conscience is an accentuation

of a reason against emotions.

Conscience in psychology

Logotherapy is directed to meaningfulness of concrete in context of the structure of previous and actual life.

Conscience, „organ of meaning“. (V. E. Frankl).

Conscience in psychology

Psychoanalysis: conscience as a internalisation of

superego. (Freud).

Conscience in psychology

Analytical psychology: Archetype as a pattern of behavior.

Conscience arises from a collision of this archetype.

Conscience in philosophy

Conscience is some of key topics in philosophy, it is a centre of human persons.

From this point of view we can understand the medical ethics as very strongly anthropocentricly founded.

Large european philosophic tradition do not understand the conscience as alibistic excuse of human acts.

Conscience warns against bad acts and leads the human life to the fullest experience with its own human dignity.

Conscience in philosophy

Plato: Daimon tells to Socrates, what he should not do. It is a rational reflection of future acts. (Apology, Timaios)

Conscience in philosophy

Thomas Aquinas: Synderesis: good is to be done and pursued, and

evil is to be avoided. Consciencia: conscience is an act of practical

reason, as opposed to speculative reason, and thus has "the good" as its object in relation to particular further actions.

In relation to those particular further actions, the action of conscience may be either antecedent or consequent.

Conscience in philosophy

Kant: Pre-critial period: Conscience as an internal court. Duty to oneself. Critical period: Conscience as inborne judge, the different persons

involved in it (the “accuser”, “defender” and “judge”)

Svědomí ve filozofii

Hegel: Tension between Subjective (individual) and

Objective (society).

What is objective, is good.

We should accept this objective Good. (Phänomenologie des Geistes, Enzyklopädie der

phil. Wissenschaften, Grundlinie der Philosophie des Rechts)

Conscience in philosophy

Nietzsche: A great critic of judeo-christian morality He condemned institutionalized Christianity for

emphasizing a morality of pity, which assumes an inherent illness in society.

He emphasises all the good, joy, beauty and life. A criterion is idea o enternal return: 'This life as you now live it and have lived it, you

will have to live once more and innumerable times more' .

Conscience in philosophy

Heidegger: Conscience calls as from inauthentic to authentic

Dasein (Way of life).

Conclusion I.

What is conscience

Conclusion II:

What should the doctor do?

Thank you for your understanding!