Law Richard Wm, Choong Kartina A
Tameside & Glossop Integrated Care NHS Foundation Trust, Ashton-under-Lyne, UK.
School of Law and Social Science, University of Central Lancashire, Preston, UK.
Med Leg J. 2020 Jul;88(2):97-101. doi: 10.1177/0025817220935752. Epub 2020 Jun 12.
Medical decision-making has, across the history of the NHS, made a transitional journey from a model characterised by paternalism to one which places emphasis on partnership and patient autonomy. This article assesses the extent to which the circumstances generated by the Covid-19 pandemic affect the mode of critical care decision-making. It observes that clinical judgment influenced by protocols, algorithms and resource constraints do not lend themselves to full identification with either of the two frameworks familiar to the NHS. The unique mode of decision-making engendered can only be understood on its own terms.
在国民医疗服务体系（NHS）的历史进程中，医疗决策经历了从家长式模式到强调伙伴关系和患者自主权模式的转变。本文评估了新冠疫情所产生的情况对重症监护决策模式的影响程度。文章指出，受协议、算法和资源限制影响的临床判断并不完全符合NHS所熟悉的两种框架中的任何一种。所产生的独特决策模式只能根据其自身情况来理解。
