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接纳与患者普遍接纳的伦理及实际层面

The ethical and practical aspects of acceptance and universal patient acceptance.

作者信息

Corsino Bruce V, Patthoff Donald E

机构信息

Bioethics, Inc., Reston, Virginia, USA.

出版信息

J Dent Educ. 2006 Nov;70(11):1198-201.

Abstract

"Acceptance" is an often presupposed, hidden core value and ethic focused on how dental and other health practitioners first accept people as possible patients. The three basic styles of patient acceptance are random, selective, and universal. Reduced public access to care results from the practice of random and selective acceptance. Only universal acceptance creates a potential pathway for improved access to care. The notion of Universal Patient Acceptance (UPA) is discussed here as one kind of applied ethical tool or clinical practice that allows for the ethic of acceptance to be more effectively pursued in daily practice. We suggest that health providers falsely surmise that they already understand and practice Universal Patient Acceptance. That myth and perspective are partly what keeps Acceptance hidden as an ethic and overlooked as a potential way to foster dialogue and indirectly promote better access to care. Without Universal Patient Acceptance, dental and health providers will continue to silently engage in practice patterns that adversely affect public access to care. The actual benefits of Universal Patient Acceptance are the subject of ongoing review and debate. Whatever those benefits might be will not likely be realized until Acceptance and Universal Patient Acceptance are included as part of dental and other health professional codes of ethics and training curricula. That is what we argue for here.

摘要

“接纳”是一种常常被预设的、隐藏的核心价值观和道德准则,关注牙科及其他医疗从业者如何首先将人们接纳为潜在患者。患者接纳的三种基本方式是随机接纳、选择性接纳和普遍接纳。随机接纳和选择性接纳的做法导致公众获得医疗服务的机会减少。只有普遍接纳才能为改善医疗服务可及性创造一条潜在途径。这里讨论的普遍患者接纳(UPA)概念是一种应用伦理工具或临床实践,它能让接纳伦理在日常实践中得到更有效的践行。我们认为,医疗服务提供者错误地推测他们已经理解并践行了普遍患者接纳。这种误解和观点在一定程度上使得接纳作为一种道德准则被隐藏起来,并且被忽视作为促进对话以及间接改善医疗服务可及性的一种潜在方式。没有普遍患者接纳,牙科和医疗服务提供者将继续默默地采用那些对公众获得医疗服务产生不利影响的执业模式。普遍患者接纳的实际益处是正在进行审查和辩论的主题。在接纳和普遍患者接纳被纳入牙科及其他医疗专业伦理准则和培训课程之前,无论这些益处可能是什么,都不太可能实现。这就是我们在此所主张的。

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