School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.
Am J Phys Med Rehabil. 2013 Sep;92(9):818-27. doi: 10.1097/PHM.0b013e318292309b.
There exists a paucity of ethics resources tailored to rehabilitation. To help fill this ethics resource gap, the authors developed an ethics analysis model specifically for use in rehabilitation care. The Patient-Centered Care Ethics Analysis Model for Rehabilitation is a process model to guide careful moral reasoning for particularly complex or challenging matters in rehabilitation. The Patient-Centered Care Ethics Analysis Model for Rehabilitation was developed over several iterations, with feedback at different stages from rehabilitation professionals and bioethics experts. Development of the model was explicitly informed by the theoretical grounding of patient-centered care and the context of rehabilitation, including the International Classification of Functioning, Disability and Health. Being patient centered, the model encourages (1) shared control of consultations, decisions about interventions, and management of the health problems with the patient and (2) understanding the patient as a whole person who has individual preferences situated within social contexts. Although the major process headings of the Patient-Centered Care Ethics Analysis Model for Rehabilitation resemble typical ethical decision-making and problem-solving models, the probes under those headings direct attention to considerations relevant to rehabilitation care. The Patient-Centered Care Ethics Analysis Model for Rehabilitation is a suitable tool for rehabilitation professionals to use (in real time, for retrospective review, and for training purposes) to help arrive at ethical outcomes.
针对康复治疗,现有的伦理学资源十分匮乏。为了填补这一伦理学资源缺口,作者专门开发了一种伦理学分析模型,用于康复护理。该模型被称为“康复患者中心护理伦理学分析模型”,是一种用于指导康复治疗中特别复杂或具有挑战性问题的道德推理的流程模型。该模型历经多次迭代开发,在不同阶段都收到了康复专业人士和生物伦理专家的反馈。该模型的开发明确借鉴了以患者为中心的护理的理论基础以及康复的背景,包括《国际功能、残疾和健康分类》。作为以患者为中心的模型,它鼓励(1)与患者共同控制咨询、干预决策以及健康问题管理,(2)将患者视为一个具有个体偏好并处于社会环境中的完整个体。虽然“康复患者中心护理伦理学分析模型”的主要流程标题类似于典型的伦理决策和问题解决模型,但这些标题下的探测项则将注意力引向与康复护理相关的考虑因素。“康复患者中心护理伦理学分析模型”是康复专业人员(实时使用、回顾使用和培训使用)用来帮助得出伦理结果的合适工具。