Akabayashi Akira, Nakazawa Eisuke, Ino Hiroyasu
Department of Biomedical Ethics, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
Division of Medical Ethics, School of Medicine, New York University, 227 East 30th Street, New York, NY 10016, USA.
Clin Pract. 2022 Sep 22;12(5):760-765. doi: 10.3390/clinpract12050079.
End-of-life decision making is a troublesome ethical dilemma. These decisions should be made in trustful patient-doctor relationships. We aimed to propose a balanced approach when discussing this complex issue. We categorized the research into four approaches and suggest that a multidisciplinary approach may be appropriate. We also analyzed the pitfalls of the multidisciplinary approach. Our conclusion is two-fold. First, discussions in this field should be based on real-world practice. If this is not the case, the proposal may be armchair theory, which is not effective in a clinical setting. Second, interdisciplinary researchers should not stick to their position too firmly and should listen to others. Otherwise, proposals made will be paternalistic or philosophically biased. Therefore, when philosophical collaboration is applied to the topic of clinical bioethics, it is necessary to thoroughly examine different positions and carry out careful discussions with consideration for medical care settings. Researchers must also understand what is needed for a trustful patient-doctor relationship. By making such efforts, clinical bioethics will contribute to the wellbeing of patients.
临终决策是一个棘手的伦理困境。这些决策应该在医患之间相互信任的关系中做出。我们旨在提出一种平衡的方法来讨论这个复杂的问题。我们将相关研究分为四种方法，并认为多学科方法可能是合适的。我们还分析了多学科方法的缺陷。我们的结论有两点。首先，该领域的讨论应该基于实际的临床实践。否则，所提出的建议可能只是纸上谈兵，在临床环境中并无实效。其次，跨学科研究人员不应过于固执己见，而应倾听他人意见。否则，所提出的建议将是家长式的或存在哲学偏见。因此，当将哲学合作应用于临床生物伦理学主题时，有必要全面审视不同立场，并结合医疗环境进行仔细讨论。研究人员还必须了解建立医患信任关系所需的条件。通过做出这些努力，临床生物伦理学将有助于患者的福祉。
