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共享决策的伦理最佳实践会导致道德困扰吗?

Can the Ethical Best Practice of Shared Decision-Making lead to Moral Distress?

作者信息

Prentice Trisha M, Gillam Lynn

机构信息

Neonatal Medicine, The Royal Children's Hospital, 50 Flemington Road, Parkville, Melbourne, VIC, 3051, Australia.

Newborn Research, Royal Womens's Hospital, Melbourne, Australia.

出版信息

J Bioeth Inq. 2018 Jun;15(2):259-268. doi: 10.1007/s11673-018-9847-8. Epub 2018 Mar 14.

Abstract

When healthcare professionals feel constrained from acting in a patient's best interests, moral distress ensues. The resulting negative sequelae of burnout, poor retention rates, and ultimately poor patient care are well recognized across healthcare providers. Yet an appreciation of how particular disciplines, including physicians, come to be "constrained" in their actions is still lacking. This paper will examine how the application of shared decision-making may contribute to the experience of moral distress for physicians and why such distress may go under-recognized. Appreciation of these dynamics may assist in cross-discipline sensitivity, enabling more constructive dialogue and collaboration.

摘要

当医疗保健专业人员感到在采取符合患者最佳利益的行动时受到限制,就会产生道德困扰。医疗保健提供者普遍认识到由此产生的倦怠、低留用率以及最终糟糕的患者护理等负面后果。然而,对于包括医生在内的特定学科在其行动中如何受到“限制”,仍缺乏认识。本文将探讨共享决策的应用如何可能导致医生产生道德困扰,以及为什么这种困扰可能未得到充分认识。了解这些动态可能有助于跨学科的敏感性,促成更具建设性的对话与合作。

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