减少手术干预的伦理考虑:平衡患者的愿望与信托责任
Claudette M Lajam1,2, Lorraine H Hutzler1,2, Barron H Lerner1,2
1NYU Langone Orthopedics, New York, NY.
概括
整形外科医生面临着与高风险患者的伦理困境. 平衡患者的福祉,自主性和正义至关重要,除了质量指标和财务挑战等外部压力之外.
科学领域:
- 医学伦理 医学伦理
- 整形外科手术 整形外科手术
- 卫生政策 卫生政策
背景情况:
- 整形外科医生面临着质量指标和支付政策的越来越大的压力.
- 糟糕的外科手术结果可能会导致经济处罚,负面评级和外科医生疲劳.
- 尽管进行了优化,但一些骨科患者仍然面临并发症的高风险.
研究的目的:
- 探索骨科外科医生管理高风险手术候选人的伦理考虑.
- 检查道德原则 (仁慈,非恶性,自主,正义) 对高风险患者的应用.
- 讨论影响这些患者决策的外部力量.
主要方法:
- 对高风险的骨科患者应用的伦理原则的审查.
- 讨论外部因素:不当行为,财务挑战,质量排名.
- 分析知情同意,风险沟通和风险因素 (可修改/不可修改).
主要成果:
- 与高风险患者的决策是复杂的,受到各种因素的影响.
- 案例说明了不同的结果和道德挑战.
- 息治疗可能在管理高风险的外科候选人方面发挥作用.
结论:
- 外科医生需要合理的理由不对高风险患者进行手术.
- 利用机构资源帮助做出复杂的护理决策.
- 对患者的风险进行强有力的沟通对于知情同意至关重要.
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