Yank G R, Lindsay R J, Barber J W, Hargrove D S
Department of Psychiatric Medicine, University of Virginia School of Medicine.
Hosp Community Psychiatry. 1992 Dec;43(12):1213-7. doi: 10.1176/ps.43.12.1213.
State-university collaboration programs often create ethical dilemmas for participants because of their conflicting values, goals, and expectations. Treatment and administrative staff in state agencies often seek to create an atmosphere of managed stability rather than fostering patients' autonomy. Academic participants in collaboration programs often feel impelled to change the system, even though the goal of collaboration requires them to find common ground with state agency staff. Academic participants must decide whether collaboration programs will contribute to needed reforms without overly compromising professional and academic standards. If they cannot endorse the values and quality of care provided in state systems, they must consider whether their participation should be conditioned on an agreement to work toward change. However, even in situations that are improving, clinicians must not let temporary compromises become permanent.
州立大学合作项目常常因其相互冲突的价值观、目标和期望给参与者带来伦理困境。州立机构中的治疗和行政人员往往试图营造一种管理稳定的氛围，而非促进患者的自主性。合作项目中的学术参与者常常感到有动力去改变系统，尽管合作的目标要求他们与州立机构工作人员找到共同点。学术参与者必须决定合作项目是否会有助于所需的改革，同时又不会过度损害专业和学术标准。如果他们无法认可州立系统所提供的价值观和护理质量，就必须考虑其参与是否应以致力于变革的协议为条件。然而，即使在情况正在改善的情形下，临床医生也绝不能让临时的妥协变成永久性的。
