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加拿大家庭医生的伦理决策

Ethical decision making by Canadian family physicians.

作者信息

Christie R J, Hoffmaster C B, Stewart M A

机构信息

Department of Family Medicine, University of Western Ontario, London.

出版信息

CMAJ. 1987 Nov 15;137(10):891-7.

Abstract

Canadian family physicians were sent questionnaires that asked how they would handle the ethical problems posed by six sample cases and what reasons were relevant to their decisions. The ethical problems concerned how much information to divulge to patients, how extensively a physician should become involved in the lifestyles of patients and how to deal with a possible family problem. The study identified characteristics of family physicians that affect their ethical decision making and tested a theoretical model that regards ethical problems as conflicts between respecting patient autonomy and promoting patient welfare. The varied responses suggested that ethical issues are resolved on a case-by-case, rather than a theoretical, basis. Certification in family medicine was the only characteristic associated with a consistent pattern of responses; certificants were more likely than other physicians to involve patients in decisions.

摘要

加拿大的家庭医生收到了调查问卷,询问他们将如何处理六个示例案例所带来的伦理问题,以及哪些理由与他们的决定相关。这些伦理问题涉及向患者透露多少信息、医生应在多大程度上参与患者的生活方式以及如何处理可能出现的家庭问题。该研究确定了影响家庭医生伦理决策的特征,并测试了一个理论模型,该模型将伦理问题视为尊重患者自主权与促进患者福祉之间的冲突。不同的回答表明,伦理问题是根据具体情况而非理论基础来解决的。家庭医学认证是与一致的回答模式相关的唯一特征;获得认证的医生比其他医生更有可能让患者参与决策。

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