Wall L L
Department of Anthropology, Washington University, St. Louis, Missouri, USA.
Int J Gynaecol Obstet. 2007 Nov;99 Suppl 1:S32-9. doi: 10.1016/j.ijgo.2007.06.020. Epub 2007 Aug 31.
The plight of women in poor nonindustrialized countries who have incurred catastrophic childbirth injuries, such as vesico-vaginal and recto-vaginal fistulas, from prolonged obstructed labor is receiving increased attention from the world medical community. While the good intentions that have prompted this greater concern are not in doubt, intentions by themselves are insufficient guarantees of ethical conduct in programs developed to repair these injuries. Clinical proposals put forward to deal with the problem of fistula must undergo critical analysis to insure that basic ethical requirements are met. This article emphasizes the vulnerability to exploitation of women with obstetric fistulas and reviews the basic principles of medical ethics relevant to fistula care.
在贫困的非工业化国家，妇女因长时间分娩受阻而遭受灾难性分娩损伤，如膀胱阴道瘘和直肠阴道瘘，这一困境正日益受到世界医学界的关注。促使人们更加关注这一问题的善意毋庸置疑，但善意本身并不能充分保证在为修复这些损伤而制定的项目中遵循道德行为准则。为解决瘘管问题而提出的临床方案必须经过批判性分析，以确保满足基本的道德要求。本文强调了患有产科瘘管病的妇女容易受到剥削的情况，并回顾了与瘘管护理相关的医学伦理基本原则。
