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精神科医生关于性别认同和性取向的伦理论述:一项定性研究。

Ethical Discourse of Psychiatrists About Gender Identity and Sexual Orientation: A Qualitative Study.

出版信息

Turk Psikiyatri Derg. 2020 Spring;31(1):31-40. doi: 10.5080/u23338.

Abstract

OBJECTIVE

In Turkey, the studies that aim to elaborate on the experiences of people with gender identities and sexual orientations incongruent with social norms are limited both in bioethics and in psychiatry. The general aim of this study is to provide a deeper understanding about the value based problems related to the gender identity and sexual orientation of the patients who seek medical advice in psychiatry practice. In this study, psychiatrists' discourse on gender identity and sexual orientation is discussed from an ethical perspective based on their experiences in providing healthcare to LGBT individuals.

METHOD

In-depth interviews with 35 Psychiatry residents and specialists were conducted in the context of a qualitative field study. The data received from in-depth interviews were evaluated using the thematic content analysis method.

RESULTS

The raw data received from the in-depth interviews with psychiatrists were analyzed and the themes and the contexts were derived. Discrimination, LGBTs access to healthcare services, counselling practice, beneficence, non-maleficence, being empathic, self-improvement, communicating with the family and interaction with LGBTs are the main themes that emerged. These main themes were handled within the contexts of providing healthcare services, professional responsibility of the psychiatrists, physician-patient/client and family relations. The relationship between the themes and the contexts were interpreted from an ethical perspective.

CONCLUSION

The results of the study show that in the absence of comprehensive and adequate education on gender identity and sexual orientation, psychiatrists may tend to adopt scientifically debatable METHODS in diagnosis, observation and treatment of LGBT patient/ counselee.

摘要

目的

在土耳其,旨在阐述与社会规范不一致的性别认同和性取向的人群的经验的研究,无论是在生物伦理学还是精神病学领域都非常有限。本研究的总体目的是深入了解与寻求精神病学实践中医疗咨询的患者的性别认同和性取向相关的基于价值观的问题。在这项研究中,根据他们为 LGBT 个体提供医疗保健的经验,从伦理角度讨论了精神科医生对性别认同和性取向的看法。

方法

在定性实地研究的背景下,对 35 名精神病学住院医师和专家进行了深入访谈。使用主题内容分析法对从深入访谈中获得的数据进行评估。

结果

对精神科医生的深入访谈所获得的原始数据进行了分析,并得出了主题和背景。歧视、LGBT 获得医疗保健服务、咨询实践、善行、不伤害、富有同情心、自我提升、与家人沟通和与 LGBT 互动是出现的主要主题。这些主要主题是在提供医疗服务、精神科医生的专业责任、医患关系和家庭关系的背景下处理的。从伦理角度解释了主题与背景之间的关系。

结论

研究结果表明,在缺乏全面和充分的性别认同和性取向教育的情况下,精神科医生可能倾向于在 LGBT 患者/咨询者的诊断、观察和治疗中采用科学上有争议的方法。

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