Ogino Mieko
Office of Medical Education, International University of Health and Welfare, School of Medicine.
Brain Nerve. 2020 Jul;72(7):677-687. doi: 10.11477/mf.1416201585.
Neurologists encounter patients who develop diseases that suddenly change their life one day, such as stroke, and diseases that are difficult to cure and progressive, such as intractable neurological diseases. There are many types of ethical issues, including the choice of medical intervention, caregiver conflict, genetic disease issues, end-of-life issues, etc. In this article, I will describe the matters advocated in general clinical ethics and discuss the interpretation and application in the field of neurology based on my own experience. The issue is why clinical ethics is necessary, methodologies and systems for dealing with ethical issues, four principles of clinical ethics, Jonsen's four contingency table, ethical consultation, application in neurological diseases, and issues to be noted.
神经科医生会遇到这样的患者,他们罹患的疾病会在某一天突然改变其生活,比如中风,还有一些难以治愈且呈进行性发展的疾病,比如难治性神经系统疾病。存在多种伦理问题,包括医疗干预的选择、照护者冲突、遗传疾病问题、临终问题等等。在本文中,我将描述一般临床伦理学所倡导的事项,并根据我自己的经验讨论在神经学领域的解读与应用。问题包括临床伦理学为何必要、处理伦理问题的方法和体系、临床伦理学的四项原则、琼森的四格表、伦理咨询、在神经系统疾病中的应用以及需要注意的问题。