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生物伦理学对临床执业医师来说有着不可避免的相关性。

The inescapable relevance of bioethics for the practicing clinician.

作者信息

Carrese Joseph A, Sugarman Jeremy

机构信息

Program on Ethics in Clinical Practice, Phoebe R. Berman Biorthics Institute, and Division of General Internal Medicine, Johns Hopkins University, 4940 Eastern Avenue, Baltimore, MD 21224, USA.

出版信息

Chest. 2006 Dec;130(6):1864-72. doi: 10.1378/chest.130.6.1864.

Abstract
  1. Historically, medical ethics focused on the proper conduct of physicians as members of a profession. 2. Bioethics has emerged as a distinct field over the past several decades and has a broader scope than traditional medical ethics. The field of bioethics includes research ethics, public health ethics, organizational ethics, and clinical ethics. 3. Several factors contributed to the emergence of bioethics, helping to shape it, including the following: abuses of human subjects in research; advances in medical therapeutics and medical technology; and complex societal changes. 4. Principlism is an important approach to ethics, and in bioethics it includes the following core principles: respect for autonomy; beneficence; nonmaleficence; and justice. 5. Clinical ethics is a major part of bioethics and is concerned with ethical issues encountered in the care of patients. 6. Clinicians should recognize that every interaction between a doctor and a patient has a moral component, and that competency in bioethics is required to competently practice medicine. 7. Deficiencies exist in bioethics knowledge and performance among practicing clinicians and trainees; therefore, bioethics education is needed for learners at all levels (i.e., medical students, trainees, and practicing clinicians). 8. Bioethics is a dynamic, multidisciplinary field with several dedicated journals, a national organization, and numerous centers and institutes. 9. Important scholarly work in bioethics, both empirical and conceptual, is being conducted and disseminated, providing important information for practicing clinicians.
摘要
  1. 历史上,医学伦理关注的是作为职业群体成员的医生的恰当行为。2. 在过去几十年中,生物伦理学已发展成为一个独特的领域,其范围比传统医学伦理更广泛。生物伦理学领域包括研究伦理、公共卫生伦理、组织伦理和临床伦理。3. 有几个因素促成了生物伦理学的出现并对其形成产生了影响,包括以下方面:研究中对人类受试者的滥用;医学治疗和医疗技术的进步;以及复杂的社会变革。4. 原则主义是一种重要的伦理学方法,在生物伦理学中它包括以下核心原则:尊重自主性;有利;不伤害;和公正。5. 临床伦理是生物伦理学的一个主要部分,关注在患者护理中遇到的伦理问题。6. 临床医生应认识到医生与患者之间的每一次互动都有道德成分,并且要胜任医学实践就需要具备生物伦理学能力。7. 执业临床医生和实习生在生物伦理学知识和表现方面存在不足;因此,各级学习者(即医学生、实习生和执业临床医生)都需要接受生物伦理学教育。8. 生物伦理学是一个动态的多学科领域,有几本专门的期刊、一个全国性组织以及众多中心和研究所。9. 生物伦理学领域正在进行并传播重要的学术工作,包括实证研究和概念研究,为执业临床医生提供重要信息。

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