Sine David M, Sharpe Virginia A
National Center for Patient Safety, the Veterans Health Administration, USA.
J Healthc Risk Manag. 2011;31(1):32-7. doi: 10.1002/jhrm.20077.
Patient-centered care is driven in part by the ethical principle of autonomy and considers patients' cultural traditions, personal preferences, values, family situations, and lifestyles. Patient decision-making capacity, surrogate decision making with or in the absence of a patient's advance directive, and the right to refuse treatment are three patient-care issues that are central to the work done by both the risk manager and the clinical ethicist that have strong relevance to patient-centered care. This article discusses these three issues briefly and offers two challenging case studies involving patient-centered care that illustrate how a clinical ethics consultation may help to avert the escalation that can lead to a tort claim.
以患者为中心的护理部分是由自主伦理原则驱动的，并考虑患者的文化传统、个人偏好、价值观、家庭情况和生活方式。患者的决策能力、有无预先指示时的替代决策以及拒绝治疗的权利是风险管理者和临床伦理学家工作中的三个核心患者护理问题，与以患者为中心的护理密切相关。本文简要讨论这三个问题，并提供两个具有挑战性的以患者为中心的护理案例研究，说明临床伦理咨询如何有助于避免可能导致侵权索赔的纠纷升级。
