Schiedermayer D L, La Puma J, Miles S H
Department of Medicine, Medical College of Wisconsin, Milwaukee 53226.
Arch Intern Med. 1989 Jun;149(6):1303-5.
The ethical and economic aspects of treatment decisions are often intimately entwined. We demonstrate how clinical economic questions were raised in clinical ethics consultations involving three patients: a 49-year-old retarded man who required short-term tube feeding; a 74-year-old man with metastatic prostatic cancer whose relatives disagreed about whether or not he should have surgical treatment; and a 55-year-old man whose health maintenance organization declined to pay for liver transplantation. Ethics consultants can help to clarify financial constraints and to resolve financial conflicts of interest. All physicians must develop the ability to unmask economic issues in medical care.
治疗决策中的伦理和经济方面常常紧密相连。我们展示了在涉及三名患者的临床伦理咨询中是如何提出临床经济问题的：一名49岁需要短期鼻饲的智障男子；一名74岁患有转移性前列腺癌的男子，其亲属对于他是否应接受手术治疗存在分歧；以及一名55岁的男子，其健康维护组织拒绝支付肝移植费用。伦理顾问有助于厘清财务限制并解决财务利益冲突。所有医生都必须培养揭示医疗中经济问题的能力。
