A medical instrument includes a handle on the proximal end and a shank rotatably arranged on the handle. A tool is arranged on the distal end of the shank. This tool is rotatable relative to the shank. An actuation element is arranged on the handle. The actuation element may be moved into at least two switch positions, wherein in a first switch position the actuation element is coupled in movement to the shank and in a second switch position the actuation element is coupled in movement to the tool.