[Ethical problems in internal medicine]

In medical and scientific work a physician cannot act without first weighing the issues. This is often purely a weighing of utility and risks; sometimes, however, the issues must be weighted against the background of an image of the human being in which psychological and ethical aspects require consideration. Weighing of the issues is therefore possible only on the basis of expert grounding in the latest discoveries in each particular field, and in such cases also on the foundation of anthropological knowledge and awareness of ethical principles ("nil nocere"). In internal medicine weighing of the issues covers the patient's history, diagnostic and therapeutic measures, and prophylaxis. At a time when cost restraint in health care is necessary to preserve the state's finances and therewith the common good, one issue to be weighed is whether a cost-intensive diagnostic or therapeutic measure is justified in the individual case. In therapy the weighing of issues in the clinic may, however, produce a different result from that in general practice.