巴西的提前护理计划
Natália Rocha Tardelli1, Daniel Neves Forte2, Edison Iglesias de Oliveira Vidal1
1Geriatrics division, Internal Medicine Department, Botucatu Medical School, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil.
概括
巴西的提前护理计划 (ACP) 被一种父权主义文化和健康不平等所阻碍. 这可能导致弱势群体通过预先指令 (AD) 面临强制性的医疗保健做法.
科学领域:
- 生物伦理学生物伦理学
- 公共卫生 公共卫生
- 医学社会学 医学社会学
背景情况:
- 巴西的预先指示 (AD) 规定缺乏法律颁布,依赖于联邦医疗委员会规范.
- 辩论通常集中在对AD的交易方法上,忽视了预先护理规划 (ACP) 的关系模型.
- 息护理课程是巴西ACP的主要教育背景.
研究的目的:
- 分析目前巴西预先护理计划 (ACP) 的情况.
- 在巴西的背景下,确定与ACP实施相关的障碍和潜在风险.
- 探索医疗保健文化和不平等对非洲和非洲国家和地区实践的影响.
主要方法:
- 对巴西关于AD和ACP的现有文献和监管框架的定性分析.
- 讨论新兴的非洲国家和地区模式,强调关系方面.
- 检查息护理和医疗保健专业人员培训的作用.
主要成果:
- 非洲国家和地区的教育和实践集中在息护理服务中,限制了获取.
- 关于ACP的谈话往往发生在疾病进展的晚期,因为人们对息治疗的准入有限.
- 一种父权主义的医疗保健文化,加上健康不平等,构成了有效ACP的重大障碍.
结论:
- 巴西目前的医疗保健文化是ACP广泛采用的主要障碍.
- 存在很大的风险,即ACP被滥用,作为对弱势群体的强制工具.
- 解决健康不平等问题和促进共享决策教育对于ACP道德实施至关重要.
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