Department of Radiology, University of Utah, School of Medicine, Salt Lake City, Utah 84132-2140, USA.
J Am Coll Radiol. 2012 Apr;9(4):251-5. doi: 10.1016/j.jacr.2011.11.017.
There is contention within the medical community surrounding imaging self-referral, in which providers refer patients to imaging facilities from which they receive financial returns. Controversy surrounds the assertion that self-referral leads to overutilization, or the application of imaging resources and services in situations in which patients are unlikely to benefit. Proponents of self-referral claim that the practice provides increased convenience, timelier diagnosis, more expeditious treatment, and decreased cost, while opponents believe that the practice results in the inappropriate ordering of unnecessary imaging studies. Given the importance of this subject and the magnitude of its potential economic impact, it is important to restore objectivity. The 4 core principles of medical ethics--autonomy, nonmaleficence, beneficence, and justice--represent a useful and well-established paradigm. This review article addresses the question of whether self-referral upholds these 4 principles and thus whether it is an ethical practice.
在医疗界，对于医生将患者转介到自己从中获得经济回报的影像检查机构的行为，即影像检查自我 referral 存在争议。争议的焦点在于自我 referral 是否会导致过度使用，即是否在不太可能使患者受益的情况下使用影像资源和服务。自我 referral 的支持者声称，这种做法提供了更大的便利性、更及时的诊断、更迅速的治疗和更低的成本，而反对者则认为这种做法导致不必要的影像检查的不当开具。鉴于这个问题的重要性及其潜在的巨大经济影响，恢复客观性很重要。医学伦理的 4 个核心原则——自主性、不伤害、有益和公正——代表了一个有用且成熟的范例。这篇综述文章探讨了自我 referral 是否符合这 4 个原则，因此是否是一种合乎道德的做法。
