Low Lisa, Purvis Rachel S, Cunningham Thomas V, Chughati Almas, Garner Robert, McElfish Pearl A
Narrat Inq Bioeth. 2019;9(1):53-62. doi: 10.1353/nib.2019.0018.
Marshallese migrating to the United States face numerous challenges in accessing health care and managing illness and chronic disease. This study explores health care providers' perceptions of and experiences with ethical dilemmas as they care for Marshallese patients. Utilizing a qualitative research design, we interviewed 21 providers to explore the ethical dilemmas they encountered while treating Marshallese patients. We used the framework of bioethical principlism to categorize and describe the ethical dilemmas reported by those providers. When explicitly asked whether they experienced such situations, approximately half (10/21) affirmed that they had, and analysis of the qualitative data indicated that all interviewees described an ethical dilemma at least once during their interviews. We characterized providers' ethical dilemmas in terms of conflicts that arise when prioritizing different ethical principles in the care of this complex patient population, including the principles of respect for autonomy, nonmaleficence, beneficence, and justice.
移民到美国的马绍尔人在获得医疗保健以及管理疾病和慢性病方面面临诸多挑战。本研究探讨了医疗保健提供者在照顾马绍尔患者时对伦理困境的看法和经历。采用定性研究设计，我们采访了21名提供者，以探讨他们在治疗马绍尔患者时遇到的伦理困境。我们使用生物伦理原则主义框架对这些提供者报告的伦理困境进行分类和描述。当被明确问及是否经历过此类情况时，大约一半（10/21）的人确认有过，对定性数据的分析表明，所有受访者在采访中至少描述了一次伦理困境。我们根据在照顾这一复杂患者群体时优先考虑不同伦理原则时出现的冲突，对提供者的伦理困境进行了描述，这些原则包括尊重自主权、不伤害、行善和公正。
