Doukas D J
Department of Family Practice, University of Michigan Medical School, Ann Arbor 48109.
Theor Med. 1992 Mar;13(1):5-14.
The emergence of the ethics consultation as a means to resolve moral crises in clinical medicine has revealed the need for a worksheet that would facilitate intake and analysis. The author developed the "Bioethics Consultation Form" as an attempt to remedy this need. The form is arranged in an outline format and is a useful asset to ethics committee discussions and record keeping. The first section covers basic intake data concerning the patient's medical and personal information, advance directives, and values, as well as the values of the physician and family. After the intake section is completed with the above data, the ethics consultant then turns to the analysis section. This second section allows for (1) the discussion of conflicting values, (2) the identification of priorities, and (3) the elucidation of ethical norms relevant to the case. The Bioethics Consultation Form was adopted by the Patient Care Advisory committee of the Franklin Square Hospital Center in Baltimore, Maryland in 1986. The methodology in the use of the form will be discussed. Further, the potential spectrum of consultative cases that can be analyzed using the form will be highlighted.
伦理咨询作为解决临床医学中道德危机的一种手段出现后,表明需要一种有助于收集信息和分析的工作表。作者开发了“生物伦理咨询表”来满足这一需求。该表格采用大纲格式,是伦理委员会讨论和记录保存的有用工具。第一部分涵盖有关患者医疗和个人信息、预先医疗指示及价值观,以及医生和家属价值观的基本信息收集数据。在上述数据填完信息收集部分后,伦理顾问接着进入分析部分。第二部分允许(1)讨论相互冲突的价值观,(2)确定优先事项,以及(3)阐明与该病例相关的伦理规范。1986年,马里兰州巴尔的摩市富兰克林广场医院中心的患者护理咨询委员会采用了生物伦理咨询表。将讨论使用该表格的方法。此外,还将突出可以使用该表格分析的潜在咨询案例范围。