Hannover Medical School, Institute for History, Ethics and Philosophy in Medicine, CELLS-Centre for Ethics and Law in the Life Sciences, Carl-Neuberg Straße 1, 30625 Hanover, Germany.
Br J Psychiatry. 2013 Jun;202:400-6. doi: 10.1192/bjp.bp.112.116335.
Integrating ethical issues in dementia-specific training material, clinical guidelines and national strategy plans requires an unbiased awareness of all the relevant ethical issues.
To determine systematically and transparently the full spectrum of ethical issues in clinical dementia care.
We conducted a systematic review in Medline (restricted to English and German literature published between 2000 and 2011) and Google books (with no restrictions). We applied qualitative text analysis and normative analysis to categorise the spectrum of ethical issues in clinical dementia care.
The literature review retrieved 92 references that together mentioned a spectrum of 56 ethical issues in clinical dementia care. The spectrum was structured into seven major categories that consist of first- and second-order categories for ethical issues.
The systematically derived spectrum of ethical issues in clinical dementia care presented in this paper can be used as training material for healthcare professionals, students and the public for raising awareness and understanding of the complexity of ethical issues in dementia care. It can also be used to identify ethical issues that should be addressed in dementia-specific training programmes, national strategy plans and clinical practice guidelines. Further research should evaluate whether this new genre of systematic reviews can be applied to the identification of ethical issues in other cognitive and somatic diseases. Also, the practical challenges in addressing ethical issues in training material, guidelines and policies need to be evaluated.
将伦理问题融入专门针对痴呆症的培训材料、临床指南和国家战略计划中，需要对所有相关伦理问题有一个公正的认识。
系统而透明地确定临床痴呆症护理中所有伦理问题的全貌。
我们在 Medline（仅限于 2000 年至 2011 年期间发表的英文和德文文献）和 Google 书籍（无限制）中进行了系统综述。我们应用定性文本分析和规范分析对临床痴呆症护理中的伦理问题进行分类。
文献综述检索到 92 篇参考文献，这些文献共提到了临床痴呆症护理中 56 个伦理问题。该图谱分为七个主要类别，其中包含了伦理问题的一阶和二阶类别。
本文系统地得出了临床痴呆症护理中伦理问题的图谱，可以作为医疗保健专业人员、学生和公众的培训材料，以提高他们对痴呆症护理中伦理问题复杂性的认识和理解。它还可以用于确定在专门针对痴呆症的培训计划、国家战略计划和临床实践指南中应解决的伦理问题。进一步的研究应评估这种新的系统综述方法是否可用于确定其他认知和躯体疾病中的伦理问题。此外，还需要评估在培训材料、指南和政策中解决伦理问题的实际挑战。
