Howe Edmund
Dr. Howe is Professor, Department of Psychiatry, Director, Programs in Medical Ethics, and Senior Scientist, Center for the Study of Traumatic Stress, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
Innov Clin Neurosci. 2014 Jan;11(1-2):32-8.
This article explores several contexts in which psychiatrists may face having to decide whether to make exceptions to rules or guidelines when treating their patients. Contexts discussed include paternalistically going against a patient's autonomy, violating professional psychiatric standards of care, and clashing with some kind of institutional policy. The author contends that standard guidelines cannot possibly apply optimally to all patients, and thus there will be times when exceptions to these guidelines must be made by the psychiatrist. In addition to discussing the ethical considerations, the author offers some suggestions when faced with certain conflicting situations.
本文探讨了几种情况，在这些情况下，精神科医生在治疗患者时可能不得不决定是否对规则或指导方针做出例外处理。所讨论的情况包括家长式地违背患者的自主权、违反专业精神科护理标准以及与某种机构政策发生冲突。作者认为，标准指导方针不可能对所有患者都达到最佳适用，因此精神科医生有时必须对这些指导方针做出例外处理。除了讨论伦理考量外，作者还针对某些冲突情况提供了一些建议。
