Ethics Committee, Memorial Sloan Kettering Cancer Center, New York, New York, USA
Ethics Committee, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
J Med Ethics. 2023 Apr;49(4):240-243. doi: 10.1136/medethics-2021-107426. Epub 2021 Nov 3.
Clinical ethics consultations exist to support patients, families and clinicians who are facing ethical or moral challenges related to patient care. They provide a forum for open communication, where all stakeholders are encouraged to express their concerns and articulate their viewpoints. Ethics consultations can be requested by patients, caregivers or members of a patient's clinical or supportive team. Although and by extension their families (especially in cases of decisional incapacity) are the common denominators in most ethics consultations, these constituents are the likely to request them. At many healthcare organisations in the USA, ethics consultations are overwhelmingly requested by physicians and other clinicians. We believe it is vital that healthcare institutions bridge the knowledge gaps and power imbalances over access to ethics consultation services through augmented policies, procedures and infrastructure. With enhanced education and support, patients and families may use ethics consultation to elevate their voices and prioritise their unique characteristics and preferences in the delivery of their healthcare. Empowering patients and families to request ethics consultation can only strengthen the patient/family-clinician relationship, enhance the shared decision-making model of care and ultimately lead to improved patient-centred care.
临床伦理咨询旨在为面临与患者护理相关的伦理或道德挑战的患者、家属和临床医生提供支持。它们提供了一个开放沟通的论坛，鼓励所有利益相关者表达他们的关切并阐明他们的观点。患者、护理人员或患者的临床或支持团队的成员可以请求进行伦理咨询。尽管患者及其家属（尤其是在决策能力丧失的情况下）是大多数伦理咨询中的常见因素，但这些人不太可能请求进行伦理咨询。在美国的许多医疗保健机构中，伦理咨询主要是由医生和其他临床医生请求的。我们认为，医疗机构通过增强政策、程序和基础设施来弥合获取伦理咨询服务方面的知识差距和权力失衡至关重要。通过加强教育和支持，患者和家属可以利用伦理咨询来提高他们的声音，并在提供医疗保健服务时优先考虑他们的独特特征和偏好。赋予患者和家属请求伦理咨询的权力，只能加强医患关系，增强以共享决策为基础的护理模式，并最终导致以患者为中心的护理的改善。
