Foglia Mary Beth, Pearlman Robert A
Ethics Evaluation Service, National Center for Ethics in Health Care, Veterans Health Administration, Seattle, USA.
Health Prog. 2006 Mar-Apr;87(2):31-5.
Traditionally, ethics consultations are conducted one case at a time. This typical approach addresses immediate needs pertinent to the case, but seldom looks toward preventing recurrences. The underlying problem is that clinical ethics and organizational ethics are still often regarded as separate areas with separate concerns. When it comes to ethics in health care, nothing helps clarify ideas like a case study. The autopsy case mentioned in this article demonstrates that clinical cases coming before an ethics committee are impeded in and influenced by a larger organizational context. The authors say that a "systems-oriented" perspective toward ethics consultation would help committee members view cases through the widest possible lens. This would enable committees to look at the larger system and thereby propose strategies for anticipated repeat problems.
传统上，伦理咨询是逐案进行的。这种典型的方法解决了与该案例相关的紧迫需求，但很少着眼于预防复发。根本问题在于，临床伦理和组织伦理仍常常被视为有着不同关注点的不同领域。在医疗保健伦理方面，没有什么比案例研究更有助于理清思路了。本文提到的尸检案例表明，提交给伦理委员会的临床案例受到更大的组织背景的阻碍和影响。作者表示，对伦理咨询采用“以系统为导向”的视角将有助于委员会成员从尽可能广阔的视角看待案例。这将使委员会能够审视更大的系统，从而针对预期的重复问题提出策略。
