Heinze Katherine E, Holtz Heidi K, Rushton Cynda H
Hecht-Levi Postdoctoral Fellow at the Johns Hopkins Berman Institute of Bioethics in Baltimore, and a postdoctoral fellow in palliative care at the Johns Hopkins University School of Nursing.
Hecht-Levi Postdoctoral Fellow at the Johns Hopkins Berman Institute of Bioethics in Baltimore, and a postdoctoral fellow at the Johns Hopkins Hospital.
AMA J Ethics. 2017 Jun 1;19(6):601-607. doi: 10.1001/journalofethics.2017.19.6.pfor2-1706.
Palliative care (PC) clinicians are faced with ever-expanding pressures, which can make it difficult to fulfill their duties to self and others and lead to moral distress. Understanding the pressures that PC clinicians face and the resources that could be employed to ease their moral distress is crucial to maintaining a healthy PC workforce and to providing necessary PC services to patients. In this paper, we discuss recommendations related to two promising pathways for supporting PC clinicians in providing high-quality PC: (1) improving systemic PC delivery and (2) strategies to promote ethical practice environments and individual resilience. Enacting these recommendations holds promise for sustaining higher-quality and accessible PC and a more engaged PC workforce.
姑息治疗（PC）临床医生面临着不断增加的压力，这可能使他们难以履行对自己和他人的职责，并导致道德困扰。了解PC临床医生面临的压力以及可用于缓解其道德困扰的资源，对于维持健康的PC工作队伍以及为患者提供必要的PC服务至关重要。在本文中，我们讨论了与支持PC临床医生提供高质量PC的两条有前景的途径相关的建议：（1）改善系统性PC服务的提供，以及（2）促进道德实践环境和个人复原力的策略。实施这些建议有望维持更高质量且可及的PC服务以及更敬业的PC工作队伍。
