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医院牧师在做出艰难医疗决策中的伦理顾问作用。

Hospital chaplains as ethical consultants in making difficult medical decisions.

机构信息

Chair and Department of Humanities and Social Medicine, Medical University of Lublin, Lublin, Poland

出版信息

J Med Ethics. 2022 Apr;48(4):256-260. doi: 10.1136/medethics-2020-107096. Epub 2021 Mar 15.

Abstract

BACKGROUND AND AIMS

Few Polish hospitals have Hospital Ethics Committee (HECs) and the services are not always adequate. In this situation, the role of HECs, in providing, among others, ethical advice on the discontinuation of persistent therapies, may be taken over by other entities. The aim of our research was to investigate, how often and on what issues hospital chaplains are asked for ethical advice in reaching difficult medical decisions.

METHODS

A survey of 100 Roman Catholic chaplains was conducted, that is, at least 10% of all chaplains currently working in Polish hospitals.

RESULTS

Of the participants, 29% confirmed receiving requests for advice in making a morally difficult medical decision. Receiving this type of request was not conditional on the place of their service, duration of their pastoral mission or HEC membership. The largest group of chaplains (21%) encounter questions concerning the ethical dilemmas associated with discontinuing persistent therapy. Patients and their families most often raise issues related to the methods of birth control, and the medical staff raise the issue of termination of pregnancy-as reported by 9% and 15% of chaplains, respectively. Most of the chaplains asked for help (79%) experience a deficit of specialist knowledge in the area of medicine or ethics.

CONCLUSIONS

In order to improve the quality of ethical consultations in Polish hospitals, in addition to further development of HECs, it is postulated to develop a system for bioethical education of chaplains.

摘要

背景与目的

波兰只有少数几家医院设有医院伦理委员会(HEC),且服务并不总是充分的。在这种情况下,HEC 除了为持续治疗的终止提供伦理建议外,其提供其他服务的角色可能会被其他实体所取代。本研究的目的是调查在面临困难的医疗决策时,医院牧师经常被要求提供哪些伦理建议以及在哪些问题上提供建议。

方法

对 100 名罗马天主教牧师进行了调查,即目前在波兰医院工作的牧师中至少有 10%参与了调查。

结果

29%的参与者证实收到过关于做出道德上困难的医疗决策的咨询请求。收到此类请求并不取决于他们的服务地点、牧灵使命的持续时间或 HEC 成员身份。最大的牧师群体(21%)遇到与停止持续治疗相关的伦理困境问题。患者及其家属最常提出与节育方法相关的问题,而医务人员则提出终止妊娠的问题,分别有 9%和 15%的牧师报告了这些问题。大多数寻求帮助的牧师(79%)在医学或伦理学领域都缺乏专业知识。

结论

为了提高波兰医院伦理咨询的质量,除了进一步发展 HEC 之外,还需要提出为牧师进行生物伦理教育的系统。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1085/8961752/23e2f5045636/medethics-2020-107096f01.jpg

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