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中国医疗保健中讲真话的伦理困境。

The Ethical Dilemma of Truth-Telling in Healthcare in China.

机构信息

Department of Emergency Intensive Care Unit, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuanxi Road, Wenzhou, 325000, China.

Department of Intensive Care Unit, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuanxi Road, Wenzhou, 325000, China.

出版信息

J Bioeth Inq. 2020 Sep;17(3):337-344. doi: 10.1007/s11673-020-09979-6. Epub 2020 May 11.

Abstract

Truth-telling is often regarded as a challenge in Chinese medical practices given the amount of clinical and ethical controversies it may raise. This study sets to collect and synthesize relevant ethical evidence of the current situation in mainland China, thereby providing corresponding guidance for medical practices. This study looks into the ethical issues on the basis of the philosophy of deontology and utilitarianism and the ethical principles of veracity, autonomy, beneficence, and nonmaleficence. Chinese philosophy, context and culture are also discussed to provide some suggestions for decision-making about disclosure in a medical setting. This study holds that, in order to respect the basic rights to which critically ill patients are entitled, decisions regarding truth-telling and their implementation should be carried out with thorough consideration, which can be achieved by critical thinking, well-developed and effective communication skills, the consideration of cultural context, an understanding of individual differences, and compliance with relevant laws and regulations.

摘要

在中文医疗实践中,由于可能引发大量临床和伦理争议,说实话常常被视为一项挑战。本研究旨在收集和综合中国大陆当前情况的相关伦理证据,从而为医疗实践提供相应的指导。本研究基于义务论和功利主义哲学以及真实、自主、善行和不伤害这四项伦理原则,探讨了伦理问题。同时,本研究还探讨了中国哲学、背景和文化,为医疗环境中的披露决策提供了一些建议。本研究认为,为了尊重危重症患者应享有的基本权利,应当对是否告知实情以及如何实施这一决定进行深思熟虑,这可以通过批判性思维、完善和有效的沟通技巧、对文化背景的考量、对个体差异的理解以及遵守相关法律法规来实现。

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