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临床注视、残疾和医源性伤害如何影响决策?临床医生和患者应该了解什么?

What Should Clinicians and Patients Know About the Clinical Gaze, Disability, and Iatrogenic Harm When Making Decisions?

机构信息

Associate professor in the Department of Political Science at the University of Toronto in Ontario, Canada.

Neurosurgeon and scientist at St Michael's Hospital and the Hospital for Sick Kids in Toronto, Ontario, Canada.

出版信息

AMA J Ethics. 2022 Aug 1;24(8):E762-767. doi: 10.1001/amajethics.2022.762.

DOI:10.1001/amajethics.2022.762
PMID:35976933
Abstract

While clinicians, ethicists, and policymakers are increasingly aware that race, ethnicity, sexuality, gender, and class biases interfere with care provision, disability is not always considered as a confounding factor. This article explores the way embodiment affects personal and professional values. When patients who live with bodies others might not fully comprehend or embrace refuse-or challenge-clinical interventions, they offer real opportunities for clinicians to grasp the central role that embodied experience plays in how patients make health decisions and thereby avoid harming patients or undermining their relationships with patients.

摘要

虽然临床医生、伦理学家和政策制定者越来越意识到种族、民族、性取向、性别和阶级偏见会干扰医疗服务的提供,但他们并不总是将残疾视为一个混杂因素。本文探讨了身体表现如何影响个人和职业价值观。当那些身体与他人不完全理解或接受的患者拒绝或挑战临床干预时,他们为临床医生提供了真正的机会,让他们理解身体体验在患者做出健康决策中的核心作用,从而避免伤害患者或破坏与患者的关系。

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