安大略省专业医师监管局政策和医疗保健同意法案的道德缺陷：案例审查。
Ethical failings of CPSO policy and the health care consent act: case review.
机构信息
Ontario Shores Centre for Mental Health Sciences, Whitby, ON, Canada.
University of Ottawa, Ottawa, ON, Canada.
出版信息
BMC Med Ethics. 2019 Mar 19;20(1):20. doi: 10.1186/s12910-019-0357-y.
End-of-life disputes in Ontario are currently overwhelmingly assessed through the singular lens of patient autonomy. The current dispute resolution mechanism(s) does not adequately consider evidence-based medical guidelines, standards of care, the patient's best interests, expert opinion, or distributive justice. We discuss two cases adjudicated by the Consent and Capacity board of Ontario that demonstrate the over emphasis on patient autonomy. Current health care policy and the Health Care Consent Act also place emphasis on patient autonomy without considering other ethically defensible factors. We argue that current policy and legislation require amendment, and unless there are measures undertaken to modify them, both the quality of care provided and the long-term capabilities of the health care system to remain publicly-funded, comprehensive and equitable, are at stake.
安大略省的临终争议目前主要通过患者自主权的单一视角来评估。当前的争议解决机制没有充分考虑基于证据的医学指南、护理标准、患者的最佳利益、专家意见或分配公正。我们讨论了安大略省同意和能力委员会裁决的两个案例，这些案例表明对患者自主权的过度强调。当前的医疗保健政策和《医疗保健同意法》也强调患者自主权，而不考虑其他在伦理上有辩护余地的因素。我们认为，现行政策和立法需要修订，除非采取措施加以修改，否则所提供的医疗质量和长期保持公共资助、全面和公平的医疗保健系统的能力都将受到影响。
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