Ooi Kanny
Medical Council of New Zealand, PO Box 10509, The Terrace, Wellington Central, 6143 New Zealand.
Asian Bioeth Rev. 2018 Mar 16;10(1):3-19. doi: 10.1007/s41649-018-0043-2. eCollection 2018 Mar.
Having a doctor in the family is often seen as beneficial as there is easy access to medical advice and care. It is common for doctors to treat themselves and those they are close to, and some doctors consider this their prerogative. However, there are pitfalls. Primarily, there is a risk of compromising clinical judgement and objectivity when doctors self-treat and treat those they have a close relationship with. This could lead to treating problems beyond the doctor's competence-in some instances, because someone close pressures the doctor. Other pitfalls include trivialising or overtreating a condition, failing to document the care provided, making assumptions about a person's circumstances, and breaching confidentiality. Consequently, despite good intentions, a doctor may not provide the best quality care to those they are close to. This paper examines the ethical and practical issues that arise when doctors treat themselves and those they have a close relationship with. It argues that in the vast majority of clinical situations, doctors should not engage in such care arrangements, and explains why doctors should have their own regular doctor. Several cases where doctors in New Zealand have been censured for self-treatment will be discussed. The paper compares New Zealand's position with Singapore's and explores several factors that contributed to the different positions that were adopted. The paper concludes that this is a fraught area of care so it is important that medical regulators set standards that promote best practice and that provide clear guidance to the profession and public.
家中有医生通常被视为有益之事，因为能轻松获得医疗建议和护理。医生治疗自己及亲近之人的情况很常见，一些医生认为这是他们的特权。然而，这存在一些隐患。主要的是，当医生自我治疗以及治疗与自己关系亲密的人时，存在损害临床判断和客观性的风险。这可能导致处理超出医生能力范围的问题——在某些情况下，是因为亲近的人向医生施压。其他隐患包括轻视病情或过度治疗、不记录所提供的护理、对患者情况妄加猜测以及违反保密原则。因此，尽管初衷良好，但医生可能无法为亲近之人提供最优质的护理。本文探讨了医生治疗自己及与自己关系亲密的人时出现的伦理和实际问题。文章认为，在绝大多数临床情况下，医生不应进行此类护理安排，并解释了医生为何应该有自己的固定医生。还将讨论新西兰医生因自我治疗而受到谴责的几个案例。本文将新西兰的立场与新加坡的立场进行比较，并探讨导致采取不同立场的几个因素。文章结论是，这是一个充满问题的护理领域，因此医疗监管机构制定促进最佳实践并为该行业和公众提供明确指导的标准非常重要。
