Open Access

Gustav Ferdinand Preller

• Medical doctors sometimes make diagnoses in persons who are not their patients and who did not ask for their medical opinion, e.g., when an off-duty dermatologist diagnoses melanoma in a stranger, outside of the hospital setting. These diagnoses are referred to as unsolicited medical opinions. The unsolicited medical opinion raises several ethical questions. Most importantly, it poses a moral challenge for the physician: a possible disease, which may lead to a serious loss of health, is recognised in a person who is not the physician’s patient, outside of the formal medical context. The fundamental ethical question addressed in this dissertation is: Does a medical doctor who makes a clinical diagnosis in a stranger, outside of the formal medical context, have an ethical obligation to offer an unsolicited medical opinion? This ethical question involves some related questions: If physicians do have an ethical obligation to offer an unsolicited medical opinion, are there any limiting factors to this obligation, which would justify not acting? A more practical question is also raised: How should a physician approach the person in whom an unsolicited diagnosis is made? The cumulative dissertation is based on three publications addressing the unsolicited medical opinion. Firstly, the unsolicited medical opinion is explored from the perspective of utilitarianism, and a utilitarian argument is made in favour of offering an unsolicited medical opinion. Secondly, the topic is placed in the context of the existing scientific literature and analysed from the perspective of several ethical theories: virtue ethics, care ethics, principlism and contract theory. Lastly, the unsolicited medical opinion is discussed in the context of “medically unknown symptoms”. As in the central argument of this thesis, a utilitarian principle is applied and an argument made in favour of an unsolicited mental health diagnosis.
• Ärztinnen und Ärzte stellen gelegentlich Blickdiagnosen bei Personen, die nicht um ärztlichen Rat gefragt hatten, z. B. wenn ein Dermatologe, außerhalb der Praxis, in seiner Freizeit, ein Melanom bei einer fremden Person diagnostiziert. Diese Diagnosen werden „unsolicited medical opinions“ (unaufgeforderte ärztliche Meinungen) genannt. Diese kumulative Dissertation befasst sich mit der ethischen Frage, ob Ärztinnen und Ärzte, die eine Blickdiagnose bei fremden Personen, außerhalb der Praxis oder Klinik stellen, die ethische Pflicht haben, eine unaufgeforderte ärztliche Meinung zu leisten. Die Fragestellung wird aus ethisch-theoretischer Perspektive (Tugendethik, Prinzipienethik, Sorge-Ethik und der Vertragstheorie) analysiert und es wird ein utilitaristisches Argument zugunsten der unaufgeforderten ärztlichen Meinung aufgestellt. Zusätzlich wird als Sonderfall die unaufgeforderte ärztliche Meinung im Falle von psychischen Erkrankungen betrachtet.