Centre for Social Ethics and Policy, School of Law Manchester, University of Manchester, Manchester, UK.
Health Expect. 2011 Jun;14(2):201-9. doi: 10.1111/j.1369-7625.2011.00673.x. Epub 2011 Apr 27.
To analyse whether the traditional allocation of decision-making responsibility is still justifiable. And, if not to analyse the strength of claims made by other health care professions and by patients.
Traditionally doctors have been responsible for choices of treatment, both in terms of deciding and in terms of taking responsibility for the decisions. But modern health care work often takes place in teams involving health care professionals from different professions as well as the patient. In such teams it may not be obvious who should be responsible for treatment choice.
Philosophical analysis of epistemic, ethical and organizational arguments, including analysis of the historical origins of these arguments.
The epistemic, ethical and organizational arguments for maintaining a primary decision making role for doctors are not sound. Other health care professionals can, in some circumstances make stronger and more justified claims. The arguments against allocation decision making authority to patients are also invalid or unsound in many circumstances.
There are many situations in which final responsibility for treatment choice should rest with health care professionals who are not doctors and with patients.
分析传统的决策责任分配是否仍然合理。如果不合理，分析其他医疗保健专业人员和患者提出的主张的依据。
传统上，医生在治疗选择方面承担责任，包括决策和对决策负责。但现代医疗保健工作通常在涉及不同专业的医疗保健专业人员以及患者的团队中进行。在这样的团队中，谁应该负责治疗选择可能并不明显。
对认识论、伦理和组织论点进行哲学分析，包括对这些论点的历史起源的分析。
为保持医生在主要决策中的作用而提出的认识论、伦理和组织论点站不住脚。在某些情况下，其他医疗保健专业人员可以提出更有力和更合理的主张。反对将决策权力分配给患者的论点在许多情况下也是无效或站不住脚的。
在许多情况下，最终应对治疗选择负责的应该是非医生的医疗保健专业人员和患者。
