在照顾神经性厌食症患者时的伦理问题:从伦理咨询获得的一系列文档的内容分析
Anna Lisa Westermair1,2, Stella Reiter-Theil3, Sebastian Wäscher4
1Clinical Ethics Unit, University Hospital Basel (USB), University Psychiatric Clinics (UPK) Basel, University Children's Hospital Basel (UKBB), Geriatric University Medicine Felix Platter (UAFP), Spitalstrasse 22, Basel, CH-4031, Switzerland. anna.westermair@usb.ch.
BMC medical ethics
|October 1, 2024
概括
医疗保健专业人员在治疗神经性厌食症 (AN) 时面临道德困境. 伦理困境是由于平衡患者自主权与预防伤害而产生,导致考虑非治疗方法.
科学领域:
- 医学伦理 医学伦理
- 精神病学是一个精神病学.
- 临床心理学 临床心理学
背景情况:
- 照顾神经性厌食症 (AN) 患者与医疗保健专业人员的重大道德痛苦有关.
- 一个主要的伦理冲突涉及到平衡使用胁迫来防止严重的结果,尊重患者拒绝治疗.
研究的目的:
- 调查精神性厌食症伦理咨询 (ECs) 中记录的伦理问题和患者特征.
- 为医疗保健专业人员在AN护理中所经历的道德困境提供经验证据.
主要方法:
- 从瑞士临床伦理支持服务中分析了与神经性厌食症相关的19次记录的伦理咨询.
- 在咨询文档中应用顺序演-诱导编码方法.
- 基于案例的解释开发的代码系统,以确定道德问题.
主要成果:
- 伦理咨询主要涉及严重体重不足的AN患者拒绝拟议的治疗方法.
- 伦理方面的担忧包括胁迫的合理性,强迫增加体重的潜在无效或危害,以及福利和非恶利之间的冲突.
- 确定了九种不同类型的伦理冲突或不确定性,平均每例为八种,包括减少伤害和息护理的考虑.
结论:
- 对神经性厌食症护理的伦理问题是多方面的,涉及自主性,有益性和非有害性之间的复杂相互作用.
- 医疗保健专业人员探索非治疗策略,以应对道德冲突和不确定性.
- 非治愈方法的广泛采用目前受到其理由,资格和实施协议的模糊性所限制.
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