A medical instrument with a handle arranged at the proximal end, with a shank arranged on the handle, and with a tool arranged at the distal end of the shank. The medical instrument can provide several functionalities, for example the rotation about the longitudinal axis of the medical instrument, the pivoting of the tool relative to the longitudinal axis of the medical instrument and/or the actuation of the tool, for example the opening or closing of scissors. Some of these functionalities are activated with the aid of a single common actuation element. By moving the actuation element between several switch positions, different functionalities are selected, and these are activated, e.g. by rotation of the actuation element.