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临床医生面临的道德困境的诸多表现。

The many faces of moral distress among clinicians.

作者信息

Rushton Cynda Hylton, Boss Renee, Hallett Kristina, Hensel Jaime, Humphrey G Bennett, Les Jessica, Mack Cheryl, McCammon Susan, Murray John S, Nathanson Esther, Pniewski Janet, Shuham A M t, Volpe Rebecca L

出版信息

Narrat Inq Bioeth. 2013 Fall;3(2):89-93. doi: 10.1353/nib.2013.0039.

Abstract

This narrative symposium illuminates the problem of clinician moral distress. NIB editorial staff and narrative symposium editors, Cynda Rushton, PhD, RN, FAAN and Renee Boss, MD, MHS, developed a call for stories, which was sent to several list serves and posted on Narrative Inquiry in Bioethics' website. The request for personal stories from inter-professional healthcare providers asked them to: identify specific clinical situations that give rise to moral distress; discuss the sources of this distress; reflect on how they experienced moral distress-physically, psychologically, socially, or spiritually; assess how they managed their situations; and offer suggestions for avoiding future problems of a similar nature. Twelve stories are found in the print version of the journal and an additional eight supplemental stories are published online only through Project MUSE. The clinicians describe a wide range of experiences with patients, other clinicians, and their own professional and personal identities. Embedded in each of the narratives are deeply felt emotions that accompany their experiences of moral distress. Katherine Brown-Saltzman (a nurse), Alisa Carse (a philosopher), Zhanna Bagdasarov and Shane Connelly (industrial-organizational psychologists), and Nancy Berlinger (a bioethicist) provided commentaries.

摘要

本次叙事研讨会探讨了临床医生的道德困境问题。《叙事探究生物伦理学》(Narrative Inquiry in Bioethics, NIB)编辑团队以及研讨会编辑辛达·拉什顿博士、注册护士、美国护理科学院院士(Cynda Rushton, PhD, RN, FAAN)和蕾妮·博斯医学博士、公共卫生硕士(Renee Boss, MD, MHS)发起了故事征集活动,该活动被发送至多个邮件列表服务,并发布在《叙事探究生物伦理学》的网站上。向跨专业医疗服务提供者征集个人故事的要求包括:确定引发道德困境的具体临床情况;讨论这种困境的根源;反思他们在身体、心理、社会或精神层面上如何经历道德困境;评估他们如何应对自身情况;并就避免未来类似性质的问题提出建议。在该期刊的印刷版中收录了12个故事,另外还有8个补充故事仅通过MUSE项目在线发布。临床医生们描述了与患者、其他临床医生以及他们自身专业和个人身份相关的广泛经历。在每一篇叙事中都蕴含着他们在经历道德困境时所感受到的强烈情感。凯瑟琳·布朗 - 萨尔茨曼(一名护士)、阿丽莎·卡斯(一名哲学家)、詹娜·巴格达萨罗夫和谢恩·康奈利(工业与组织心理学家)以及南希·伯林格(一名生物伦理学家)提供了评论。

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