Center for Health Professions Education, Uniformed Services University, Bethesda, MD 20814-4712, USA.
The Henry M Jackson Foundation for the Advancement of Military Medicine, Inc, 6720A Rockledge Dr, Bethesda, MD 20817, USA.
Mil Med. 2021 Oct 26;186(Suppl 3):23-28. doi: 10.1093/milmed/usab197.
The need to maintain medical ethical standards during conflict and peace has been the source of considerable academic discourse. Although still an unsolved challenge, scholars have made significant contributions to the literature, constructing categorizations that can help military providers contend with ethical conflicts. However, insights into the ethical comportment of military interprofessional healthcare teams (MIHTs) have yet to be reported.
This interview-based study collected insights from 30 military healthcare providers who participated in and/or led MIHTs. Altogether, participants represented 11 health professions, both officers and enlisted military members, and the U.S. Army, Navy, and Air Force. Following Grounded Theory methodology, data were collected and analyzed in iterative cycles until theme saturation was reached.
The research team identified two themes of ethical bearing that enable MIHT success in and across care contexts. One theme of successful ethical bearing is "raising concerns," referring to speaking up when something needs to be addressed. The other is "making compromises," where individuals have to make sacrifices (e.g., lack of equipment, non-sterile environment, etc.) to give patient care.
These data suggest that effective MIHTs have a collective moral compass. This moral compass is the team's ability to judge what is ethically right and wrong, as well as the team's willingness and ability to act accordingly-to consistently "do the right thing." There is a collective moral compass, and while the team may not all agree on what exactly is true north-they are all bending that way.
在冲突和和平时期维护医学伦理标准的需求一直是大量学术讨论的主题。尽管这仍然是一个未解决的挑战，但学者们为文献做出了重大贡献，构建了分类法，可以帮助军事医务人员应对伦理冲突。然而，关于军事多专业医疗保健团队（MIHT）的道德行为的见解尚未得到报道。
本研究采用访谈法，从参与和/或领导 MIHT 的 30 名军事医疗保健提供者那里收集了见解。总共，参与者代表了 11 个健康专业，包括军官和 enlisted 军人，以及美国陆军、海军和空军。遵循扎根理论方法，数据在迭代循环中收集和分析，直到达到主题饱和度。
研究小组确定了两个成功承载伦理的主题，这些主题使 MIHT 在护理环境中取得成功。一个成功承载伦理的主题是“提出关注”，是指在需要解决问题时发言。另一个主题是“做出妥协”，个人必须做出牺牲（例如，缺乏设备、非无菌环境等）来提供患者护理。
这些数据表明，有效的 MIHT 具有集体道德指南针。这个道德指南针是团队判断什么是道德上正确和错误的能力，以及团队愿意并能够相应地采取行动——始终“做正确的事”。有一个集体道德指南针，虽然团队可能不同意什么是真正的北方——但他们都在朝着那个方向弯曲。
