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事前指示に関する病院の方針. 医療機関では,患者の生前遺言について質問されていますか?
1Department of Health Policy and Management, Johns Hopkins University School of Hygiene and Public Health, Baltimore, Md.
JAMA
|November 3, 1989
まとめ
ほとんどの病院は,事前指示に関するポリシーを持っていますが,積極的に患者さんにそれについて尋ねる人はほとんどいません. 州の法律は政策の採択に影響を与えますが,倫理委員会は政策開発に十分に活用されていません.
科学分野:
- 保健医療政策について
- 医療倫理 医療倫理について
- 患者の権利 患者の権利
背景:
- 事前指示は一般的ですが,病院の方針は様々です.
- 現在の病院の慣行を理解することは,患者のケアを改善するために不可欠です.
研究 の 目的:
- 事前指示に関する病院の政策の普及と特徴を調査する.
- 政策の採択に影響を与える要因,例えば州立法や倫理委員会などを調査する.
主な方法:
- 394のランダムに選ばれた米国の病院にアンケートが配布されました.
- 回答した219の病院のデータを分析し,政策の存在と内容を評価した.
主要な成果:
- 病院の67%は,事前指示に関する公式なポリシーを持っています.
- ほとんどの保険には患者への通知が必要ですが,指令について積極的に問い合わせているのはわずか4%です.
- 先行指令法が制定されている州にある病院は,政策を持つ可能性が高くなった.
結論:
- 病院は,入院時に事前指示について尋ねるための積極的な政策を実施すべきである.
- 倫理委員会は,これらの政策の策定と審査により深く関与すべきである.
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