Warwick Medical School, The University of Warwick, Coventry, UK.
J Eval Clin Pract. 2011 Oct;17(5):913-9. doi: 10.1111/j.1365-2753.2011.01726.x. Epub 2011 Aug 11.
RATIONALE, AIMS AND OBJECTIVES: Patient-centred care has been a central part of US and UK health policy for over a decade, but, despite its importance, the policy literature often fails to provide an adequate theoretical justification for why and how we should value it. This omission is problematic because it renders the status, content and appropriate evaluation of patient-centredness unclear. In this paper we aim to examine two different accounts of patient-centred care.
We draw upon methods of conceptual and ethical analysis.
We argue that neither of the two accounts of patient-centred care identified appropriately grounds patient-centredness because neither of them takes into account the inherently moral nature of terms such as 'respect' and 'dignity', terms that are central to discussions of patient-centred care.
We suggest that clinical ethics can help to provide a theoretical justification for patient-centred care, and that clinical ethical practices can further patient-centred initiatives through ethics consultation, education and policy development and review.
背景、目的和目标:以患者为中心的护理已经成为美国和英国医疗政策的核心内容十余年了,但尽管其重要性不言而喻,政策文献往往未能充分说明我们为什么以及如何重视它的理论依据。这种缺失是有问题的,因为它使得以患者为中心的地位、内容和适当评估变得不明确。在本文中,我们旨在研究两种不同的以患者为中心的护理理论。
我们借鉴了概念和伦理分析的方法。
我们认为,所确定的两种以患者为中心的护理理论都没有适当地为以患者为中心提供依据,因为它们都没有考虑到“尊重”和“尊严”等术语的内在道德性质,这些术语是讨论以患者为中心的护理的核心。
我们建议临床伦理学可以为以患者为中心的护理提供理论依据,并且临床伦理实践可以通过伦理咨询、教育以及政策制定和审查来进一步推动以患者为中心的举措。