医疗保健工作人员对身体护理中的"无同意措施"的伦理反思:定性研究
Joar Björk1,2, Niklas Juth1,3, Tove Godskesen1,4
1Centre for Research Ethics & Bioethics, Uppsala University.
Nursing ethics
|April 14, 2025
概括
由于决策能力受损,医疗保健专业人员经常在没有患者同意的情况下提供干预措施. 病房文化和感知到的患者利益经常证明这些未经同意的措施是合理的,这会影响护士的权力.
科学领域:
- 医学伦理 医学伦理
- 护理实践 护理实践
- 医疗保健决策 - - 医疗保健决策
背景情况:
- 医疗病房中的许多患者缺乏决策能力,这给医疗保健专业人员带来了关于同意的伦理困境.
- 现有的研究表明,在没有同意的情况下经常提供干预措施,但了解工作人员的推理仍然有限.
研究的目的:
- 探索护士和其他医疗保健专业人员在医疗病房未经患者同意的情况下提供医疗保健干预措施的支持和反对的道德理由.
主要方法:
- 使用8个焦点小组采访的定性探索性设计,对瑞典两家医院的5个专业的37名医疗保健工作人员进行了采访.
- 数据分析遵循一个反思性主题分析框架.
主要成果:
- 出现的四个主题是:"强迫是一个坏词"",接受强迫的理由"",强迫是病房文化的一部分"和"不可接受的强迫".
- 参与者在很大程度上支持现有的"未经同意的措施",以患者利益,缺乏决策能力或对他人的利益来证明它们是合理的.
- 隐含的,上下文和机构的理由是常见的,不理想的病房文化被认为是关键的驱动因素和危害护士机构的因素.
结论:
- 当患者缺乏决策能力时,医疗保健专业人员绝大多数支持医疗病房的无同意措施.
- 病房文化对未经同意的措施的实践产生了重大影响,并可能破坏医疗保健专业人员的自主权.
- 需要对伦理框架和病房文化进行进一步的检查,以应对这些复杂的临床情况.
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