医師による自殺支援の要請に直面する: 実践的で原則に基づいた臨床スキルセットに向けて
1Institute for Ethics, American Medical Association, Chicago, IL 60610, USA.
JAMA
|August 26, 1998
まとめ
医師は,快適なケアと患者の自律性に焦点を当てた8段階のアプローチを使用して,医師による自殺支援の要請に対処することができます. この方法は,自殺に直接的な医師の関与なしに,根本的な原因を治療することによって,ほとんどの要求を解決することを目的としています.
科学分野:
- 医療倫理 医療倫理について
- クリニカル・プラクティス クリニカル・プラクティス
- 患者のケア 患者のケア
背景:
- 医師による自殺支援は,医療従事者にとって倫理的,臨床的な課題となる.
- 既存のアプローチは,患者の苦痛と自律性の複雑さを十分に解決できない可能性があります.
研究 の 目的:
- 医師による自殺支援の要請に応える医師のための8段階の構造的なアプローチを提案する.
- そのような要求の根本的な原因を特定し,治療するための枠組みを提供すること.
主な方法:
- 8段階の臨床応答プロトコルの開発.
- 患者の自律性 (望ましくない介入からの自由) と医師の義務 (快適ケア) に関するアプローチの基礎.
主要な成果:
- 提案されたアプローチは,医師による自殺補助は含まないが,特定の状況において,患者の経口摂取を拒否することを正当化している.
- このモデルは,緩和ケアとサポートケア戦略を通じて,医師による自殺支援の要求の過半数を解決することを目指しています.
結論:
- 8段階のアプローチは,基本的な倫理的原則に基づいて,医師による自殺支援の要求を管理するための臨床的に適用可能な方法を提供します.
- このアプローチの有効性を様々な患者集団で検証するために,さらなる臨床試験が推奨されます.
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