Medical ethics should be considered from the point of view of the helpless patient. N. Hartmann once defined the human being in relation to four phases: 1. inorganic (unorganisch) 2. organic (organisch) 3. psychic (seelisch) 4. spiritual (geistig). All human beings are composed of these four phases, and he describes the dominant roles in each phase. If we try to apply these concepts to medical practice, we find patients tend to see themselves in terms of the psychic and organic phases, while doctors should act in terms of the spiritual phase. So patients generally tend to desire hedonistic satisfaction, while doctors tend to pursue normative goals. These are the fundamental ethical differences between doctors and patients in the field of medical practice. Medical practice should be founded on the modern social values of respect for human dignity and happiness. Japanese medical practice in particular must try to respect these humanistic values while maintaining its traditional cultural and ethical standards. In other words our medical activity should be based not only on the American medical concept of "quality of life" , but also on the Japanese traditional attitude of caution in medical matters.
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