对于缺乏决策能力的住院囚禁患者的决策
Sarah Batbold1, Jennifer D Duke2, Kirsten A Riggan3
1Mayo Clinic Alix School of Medicine, Rochester, Minnesota.
JAMA internal medicine
|December 4, 2023
概括
住院监禁患者经常失去决策能力,引发人们对其权利的担忧. 监狱工作人员参与医疗决策可能会影响隐私和自主权,强调需要更明确的指导方针.
科学领域:
- 医学伦理 医学伦理
- 卫生法 法律 卫生法
- 监禁患者护理 监禁患者护理
背景情况:
- 住院监禁患者面临着对隐私和医疗决策中的自决权的重大威胁.
- 对失能住院监禁人员的决策过程的理解是有限的.
研究的目的:
- 确定住院监禁患者中失能患病率.
- 描述医疗决策过程,包括代孕母亲的参与和监狱员工的参与.
- 确定这些患者的护理中的伦理问题.
主要方法:
- 医疗记录的回顾性描述性和定性研究.
- 在20年 (1999-2019) 期间,对从监狱入院至少24小时的患者进行了分析.
- 在2021年3月至2022年12月期间收集的数据.
主要成果:
- 14%的监狱入院病例涉及失去能力的患者;4%需要代孕决策.
- 家庭成员在23个案例中担任了代孕,监狱雇员参与了半数入院者的决策.
- 关键主题包括对权利的不确定性,侵犯隐私,对监狱官员的尊重和患者疏远.
结论:
- 住院监禁患者缺乏能力,他们对自己的权利,隐私和自主性感到不确定.
- 临床医生需要对这个弱势群体进行道德和法律上合理的决策教育.
- 本研究提供了这些复杂的决策实践的第一个深入描述.
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