Selvaggi Gennaro, Kolby Lars, Elander Anna
Department of Plastic Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.
Plast Reconstr Surg Glob Open. 2017 Aug 3;5(8):e1437. doi: 10.1097/GOX.0000000000001437. eCollection 2017 Aug.
Different health conditions are treated in a Plastic Surgery unit, including those cases whose main goal is to enable patients to feel and integrate better within society and therefore improving quality of life, rather then physical functions.
We discuss moral principles that can be used as a guide for health professionals to revise and create policies for plastic surgery patients presenting with non-life-threatening conditions.
A specific anatomical feature is not always an indicator of patient's well-being and quality of life, and therefore it cannot be used as the sole parameter to identify the worst-off and prioritize the provision of health care. A policy should identify who preoperatively are the worst-off and come to some plausible measure of how much they can be expected to benefit from an operation. Policies that do not track these principles in any reliable way can cause discrimination.
A patient-centered operating system and patient's informed preferences might be implemented in the process of prioritizing health. In circumstances when the effectiveness of a specific treatment is unproven, professionals should not make assumptions based on their own values.
整形外科治疗各种健康状况，包括那些主要目标是使患者在社会中感觉更好并更好地融入社会从而提高生活质量而非改善身体功能的病例。
我们讨论了一些道德原则，这些原则可作为指导医疗专业人员为患有非危及生命状况的整形外科患者修订和制定政策的依据。
特定的解剖特征并不总是患者幸福和生活质量的指标，因此不能将其用作识别最贫困患者并优先提供医疗保健的唯一参数。一项政策应确定术前谁是最贫困的患者，并对他们预期能从手术中获得多大益处得出一些合理的衡量标准。不以任何可靠方式遵循这些原则的政策可能会导致歧视。
在确定医疗优先级的过程中，可以实施以患者为中心的操作系统和患者的知情偏好。在特定治疗效果未经证实的情况下，专业人员不应基于自身价值观做出假设。
