治療の制限に関する決定に関する対立: 差異診断
S D Goold1, B Williams, R M Arnold
1Division of General Medicine, University of Michigan Medical Center and Ann Arbor Veterans Affairs Medical Center, 48109-0376, USA.
JAMA
|February 24, 2000
まとめ
終末期介護における医師と家族の対立は,大変な課題です. この記事では,医療モデルである差異診断を紹介し,医師がこれらの困難な終末期の意思決定の葛藤を理解し,管理するのを助けます.
科学分野:
- 医療倫理 医療倫理について
- 緩和ケアとは,緩和ケアです.
- 紛争解決 紛争解決
背景:
- 終末期の意思決定には,医師と家族の複雑な対立がしばしば伴う.
- これらの紛争は,感情的に負担を課し,臨床実務において重要な課題を生み出します.
研究 の 目的:
- 医療モデル,特に"差異診断"を提案し,終末期の決定に関する医師と家族の対立を理解する.
- 家族,医師,組織,社会的影響からの要因 (病因) を特定し,記述する.
- これらの紛争の主な要因を診断するための戦略を提供すること.
主な方法:
- 医学的な差異診断の枠組みを用いて紛争の概念化.
- 関連する当事者 (家族,医師) の特徴と文脈的要因 (組織的,社会的) を分析する.
- 主要な紛争要素を特定するための診断戦略の開発.
主要な成果:
- 差異診断モデルは,家族,医師,および紛争に寄与するシステム的要因の重要な特徴を区別します.
- これは,終末介護の紛争の根本原因を"診断"するための構造的なアプローチを提供します.
- このモデルは,これらの複雑な状況を管理する医師に実践的な洞察を提供します.
結論:
- 差異診断のアプローチは,終末期介護の紛争をナビゲートする医師にとって貴重なツールである可能性があります.
- これらの紛争の多面的な原因を理解することは,これらの紛争を効果的に管理するのに役立ちます.
- 医療モデルを適用することで,医師と家族の紛争を体系的に分析し,解決することが可能になります.
キーワード:
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