1 School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada; and Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada.
Prehosp Disaster Med. 2013 Oct;28(5):502-8. doi: 10.1017/S1049023X13008698. Epub 2013 Jul 26.
Health professionals working in humanitarian relief projects encounter a range of ethical challenges. Applying professional and ethical norms may be especially challenging in crisis settings where needs are elevated, resources scarce, and socio-political structures strained. Situations when clinicians must decide whether to provide care that is near the margins of their professional competency are a source of moral uncertainty that can give rise to moral distress. The authors suggest that responding ethically to these dilemmas requires more than familiarity with ethical codes of conduct and guidelines; it requires practical wisdom, that is, the ability to relate past experience and general guidance to a current situation in order to render a morally sound action. Two sets of questions are proposed to guide reflection and deliberation for clinicians who face competency dilemmas. The first is prospective and intended to aid clinicians in evaluating an unfolding situation. The second is retrospective and designed to support debriefing about past experiences and difficult situations. The aim of this analysis is to support clinicians in evaluating competency dilemmas and provide ethical care and services.
在人道主义救援项目中工作的健康专业人员会遇到一系列的伦理挑战。在需求高涨、资源匮乏和社会政治结构紧张的危机环境中，应用专业和伦理规范可能尤其具有挑战性。当临床医生必须决定是否提供接近其专业能力边缘的护理时，这种情况会引起道德上的不确定性，从而导致道德困境。作者认为，要想在这些困境中做出合乎道德的回应，不仅需要熟悉道德行为准则和指南；还需要实践智慧，也就是说，能够将过去的经验和一般指导与当前情况联系起来，从而做出合理的道德行为。本文提出了两组问题，旨在为面临能力困境的临床医生提供思考和讨论的指导。第一组问题是前瞻性的，旨在帮助临床医生评估正在发生的情况。第二组问题是回顾性的，旨在支持对过去的经验和困难情况进行汇报。本文分析的目的是支持临床医生评估能力困境，并提供合乎道德的护理和服务。
