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临终决策:一项针对德国人类和兽医学健康专业人员的焦点小组研究。

End-of-life decisions: A focus group study with German health professionals from human and veterinary medicine.

作者信息

Selter Felicitas, Persson Kirsten, Kunzmann Peter, Neitzke Gerald

机构信息

Institute for Ethics, History and Philosophy of Medicine, Hannover Medical School, Hannover, Germany.

Applied Ethics in Veterinary Medicine Group, Institute for Animal Hygiene, Animal Welfare and Farm Animal Behavior, University of Veterinary Medicine Hannover Foundation, Hannover, Germany.

出版信息

Front Vet Sci. 2023 Feb 15;10:1044561. doi: 10.3389/fvets.2023.1044561. eCollection 2023.

Abstract

INTRODUCTION

At first glance, human and (companion animal) veterinary medicine share challenging processes in end-of-life (EOL) decision-making. At the same time, treatment options in both professions are substantially different. The potential of an interdisciplinary exchange between both fields has been neglected by empirical research so far.

METHODS

In this qualitative study, professionals from both fields were brought together in interdisciplinary focus groups to investigate the ethical aspects of convergences and divergences in EOL situations in human and veterinary medicine. The authors present and discuss an innovative mix of materials and methods as stimuli for discussion and for generating hypotheses.

RESULTS

The results point toward a general convergence of issues, challenges, and judgements in EOL situations in both fields, such as professional ethos, communication with the family and the role thereof as well as the ideals of death, clearly exceeding the expectations of study participants. At the same time, the study highlights a few prominent differences such as the access to patients' preferences or legal and practical constraints.

DISCUSSION

The findings suggest that using social science methods in empirical interdisciplinary biomedical-veterinary ethics could help to shed more light on this new area. Animal as well as human patients can potentially benefit from this mutual, scientifically accompanied exchange and the resulting identification and corrections of misconceptions.

摘要

引言

乍一看,人类医学和(伴侣动物)兽医学在临终(EOL)决策过程中面临着相似的挑战。与此同时,这两个专业的治疗选择却有很大不同。迄今为止,实证研究忽略了这两个领域之间跨学科交流的潜力。

方法

在这项定性研究中,来自这两个领域的专业人员被召集到跨学科焦点小组中,以调查人类医学和兽医学临终情况下趋同与分歧的伦理方面。作者展示并讨论了一种创新的材料和方法组合,作为讨论和提出假设的刺激因素。

结果

结果表明,两个领域在临终情况下的问题、挑战和判断总体上趋于一致,例如职业精神、与家属的沟通及其作用以及死亡观念等,这明显超出了研究参与者的预期。同时,该研究也突出了一些显著差异,如了解患者偏好的途径或法律和实际限制等。

讨论

研究结果表明,在实证性跨学科生物医学 - 兽医学伦理学中运用社会科学方法,有助于更深入地了解这一新兴领域。动物患者和人类患者都有可能从这种相互的、有科学依据的交流以及由此产生的对误解的识别和纠正中受益。

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