Durocher Evelyne, Gibson Barbara E
Graduate Department of Rehabilitation Sciences, Collaborative Program in Bioethics, University of Toronto, Toronto, Ontario, Canada.
Aust Occup Ther J. 2010 Feb;57(1):2-7. doi: 10.1111/j.1440-1630.2009.00826.x.
Ethical issues are becoming more complex as individuals live longer with increased disability and medical needs. This article elucidates common ethical issues encountered in discharge planning with older adults.
We conducted normative ethical analysis of a clinical case using methods of philosophical inquiry, including thick description, reflexivity, conceptual clarification and examination of competing arguments for internal consistency.
The analysis demonstrates how health-care teams struggle to balance protection from harm while honouring informed choices. We argue that ethical discharge planning requires judicious identification of client values, even if these conflict with team determinations of best interests.
Dialogue is needed to identify risks, help clients determine their personal level of acceptable risk and determine provisions to minimise risks.
随着个体寿命延长，残疾和医疗需求增加，伦理问题正变得愈发复杂。本文阐明了老年患者出院计划中常见的伦理问题。
我们运用哲学探究方法，包括深度描述、反思性思考、概念澄清以及对相互冲突观点的内部一致性检验，对一个临床案例进行了规范性伦理分析。
分析表明了医疗团队如何在保护患者免受伤害的同时尊重其知情选择方面艰难权衡。我们认为，符合伦理的出院计划需要审慎地识别患者价值观，即便这些价值观与团队对患者最佳利益的判定相冲突。
需要通过对话来识别风险，帮助患者确定其个人可接受的风险水平，并确定将风险降至最低的措施。
