使用欺骗手段促进严重创伤性脑损伤患者康复的伦理问题。
Ethical issues in using deception to facilitate rehabilitation for a patient with severe traumatic brain injury.
机构信息
Department of Clinical Neuropsychology, Barrow Neurological Institute, St Joseph's Hospital and Medical Center, Phoenix, AZ, USA.
出版信息
J Head Trauma Rehabil. 2013 Mar-Apr;28(2):126-30. doi: 10.1097/HTR.0b013e31822cc3dd.
OBJECTIVE
To explore ethical issues in using deception to improve participation in a patient with severe traumatic brain injury who had not responded to traditional behavioral and pharmacologic approaches.
DESIGN
Case study.
PARTICIPANT
A male in inpatient neurorehabilitation with history of severe traumatic brain injury and significant behavioral disruption that limited his therapy participation.
METHODS
Behavior modification program using principles of operant conditioning that required deception.
RESULTS
Participation in therapies significantly improved and disruptive behaviors decreased.
CONCLUSION
When used cautiously and with careful consideration of the ethical implications, deception may be permissible as part of an intervention strategy with this population but only as a last resort.
目的
探讨在使用欺骗手段来提高一位严重创伤性脑损伤患者的参与度方面所涉及的伦理问题，该患者对传统的行为和药物治疗方法均没有反应。
设计
案例研究。
参与者
一位男性，正在接受神经康复住院治疗，曾患有严重的创伤性脑损伤，且行为严重失调，这限制了他参与治疗的能力。
方法
采用操作性条件反射原理的行为矫正计划，需要使用欺骗手段。
结果
患者参与治疗的意愿显著提高，且行为紊乱的情况有所减少。
结论
在谨慎使用并充分考虑伦理影响的前提下，欺骗手段在针对该人群的干预策略中可能是可以接受的，但只能作为最后的手段。
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