Sine David M, Northcutt Norvell
SafetyLogic Systems, Austin, Texas, USA.
Am J Disaster Med. 2008 Nov-Dec;3(6):335-43.
Biomedical ethics decisions are often made after reflection, deliberation, and after a process of communication, reveal the values and interests of the patient or the patient's family. However, acute and rapid changes in the patient, the very public view of the care provided, and a need for rapid decision making by paramedics in a prehospital setting make protracted deliberation and reflection a practical impossibility. As paramedics provide care for patients, they regularly make value-laden choices that affect the type of care, how care is provided, and to whom care is provided. These choices transcend the technical judgment and professional skills necessary for provision of emergency care in prehospital settings. This article identifies, describes, and organizes a number of central values of professional paramedics and discusses how values may be considered by paramedics when resolving conflicting values.
生物医学伦理决策通常是在经过思考、审议以及沟通之后做出的，这些过程揭示了患者或患者家属的价值观和利益。然而，患者病情的急剧快速变化、公众对所提供护理的看法，以及急救人员在院前环境中需要迅速做出决策，使得长时间的审议和思考实际上变得不可能。在急救人员为患者提供护理时，他们经常做出充满价值判断的选择，这些选择会影响护理的类型、护理的提供方式以及护理的对象。这些选择超越了院前环境中提供紧急护理所需的技术判断和专业技能。本文识别、描述并梳理了专业急救人员的一些核心价值观，并讨论了急救人员在解决相互冲突的价值观时如何考虑这些价值观。
