Hurst S A, Reiter-Theil S, Slowther A-M, Pegoraro R, Forde R, Danis M
Institute for Biomedical Ethics, University of Geneva MedicalSchool, Geneva, Switzerland.
J Med Ethics. 2008 Apr;34(4):241-6. doi: 10.1136/jme.2006.019828.
In an international survey of rationing we have found that European physicians encounter scarcity-related ethical difficulties, and are dissatified with the resolution of many of these cases. Here we further examine survey results to explore whether ethics support services would be potentially useful in addressing scarcity related ethical dilemmas. Results indicate that while the type of help offered by ethics support services was considered helpful by physicians, they rarely referred difficulties regarding scarcity to ethics consultation. We propose that ethics consultants could assist physicians by making the process less difficult, and by contributing to decisions being more ethically justifiable. Expertise in bringing considerations of justice to bear on real cases could also be useful in recognising an unjust limit, as opposed to a merely frustrating limit. Though these situations are unlikely to be among the most frequently referred to ethics support services, ethics consultants should be prepared to address them.
在一项关于医疗资源分配的国际调查中，我们发现欧洲医生面临与资源稀缺相关的伦理困境，并且对其中许多案例的解决方式不满意。在此，我们进一步研究调查结果，以探讨伦理支持服务在解决与资源稀缺相关的伦理困境方面是否可能有用。结果表明，虽然伦理支持服务提供的帮助类型被医生认为是有帮助的，但他们很少将与资源稀缺相关的困难提交给伦理咨询。我们建议伦理顾问可以通过使过程不那么困难，并使决策在伦理上更具正当性来帮助医生。将正义考量应用于实际案例的专业知识，在识别不公正的限制（而非仅仅令人沮丧的限制）方面也可能有用。尽管这些情况不太可能是最常提交给伦理支持服务的案例，但伦理顾问应该做好处理这些情况的准备。
