减少NHS灾难的风险 减少NHS灾难的风险
1Rehabilitation Medicine, NHS Lothian, Astley Ainslie Hospital, Edinburgh, UK edwin.jesudason@nhslothian.scot.nhs.uk.
Journal of medical ethics
|November 3, 2023
概括
公共调查可以通过解决认识不公正来改善医疗保健,将重点从单纯的遗憾转移到使有害的做法违法. 这种方法,灵感来自知情同意改革,增强患者权力和促进道德领导.
科学领域:
- 医疗保健管理的管理
- 医学伦理 医学伦理
- 法律改革 法律改革
背景情况:
- 医疗保健的失败,以莱特比案为例,突出了超越个人犯罪的系统性问题.
- 当前的公众调查往往难以改革糟糕的领导和文化,专注于令人遗憾但合法的东西.
- 在知情同意方面取得的进展表明,通过解决认识不公正,成功地从不必要的做法转变为非法做法.
研究的目的:
- 建议使用公众调查来识别和纠正医疗保健系统中的认识学不公正.
- 探索知情同意改革的教训如何应用于更广泛的医疗保健领导和法律实践.
- 倡导使某些系统性失败,称为"管理封建主义"和"法律杀",是非法的.
主要方法:
- 分析公共调查结构及其在解决系统性医疗保健失败方面的局限性.
- 考察认识不公正的概念及其在医疗保健中的作用,特别是在患者同意方面.
- 建议补救措施,包括民主化管理,改革法律道德,并调整立法和诉讼策略.
主要成果:
- 确定"管理封建主义"和"法律杀"是医疗保健中认识论不公正的关键领域.
- 建议解决认识问题可以增强患者的社会权力,并改变临床医生与患者之间的关系.
- 建议通过针对这些不公正行为来推动合法变革,公众调查可以更有效.
结论:
- 公共调查应该演变为针对认识系统的不公正,超越单纯的谴责,建立新的法律标准.
- 应用知情同意原则和解决认识关系的方法可以改善医疗保健领导力和法律实践.
- 将医疗保健领导人从威权主义转变为同意,律师从保密转变为坦率,这对公众的信任和安全至关重要.
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