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绿色生命伦理学、医疗保健中的患者自主性和知情同意

Green bioethics, patient autonomy and informed consent in healthcare.

机构信息

Office of the Deputy Director, National Institute of Environmental Health Sciences, Durham, North Carolina, USA

Oxford Uehiro Centre for Practical Ethics, Oxford University, Oxford, UK.

出版信息

J Med Ethics. 2024 Jun 21;50(7):489-493. doi: 10.1136/jme-2023-109404.

Abstract

Green bioethics is an area of research and scholarship that examines the impact of healthcare practices and policies on the environment and emphasises environmental values, such as ecological sustainability and stewardship. Some green bioethicists have argued that healthcare providers should inform patients about the environmental impacts of treatments and advocate for options that minimise adverse impacts. While disclosure of information pertaining to the environmental impacts of treatments could facilitate autonomous decision-making and strengthen the patient-provider relationship in situations where patients have clearly expressed environmental concerns, it may have the opposite effect in other situations if makes patients feel like they are being judged or manipulated. We argue, therefore, that there is not a generalisable duty to disclose environmental impact information to all patients during the consent process. Providers who practice green bioethics should focus on advocating for system-level changes in healthcare financing, organisation and delivery and use discretion when bringing up environmental concerns in their encounters with patients.

摘要

绿色生命伦理学是一个研究和学术领域,它研究医疗实践和政策对环境的影响,并强调环境价值观,如生态可持续性和管理。一些绿色生命伦理学家认为,医疗保健提供者应该告知患者治疗的环境影响,并倡导选择最小化不利影响的方案。虽然披露与治疗的环境影响有关的信息可以促进自主决策,并在患者明确表示环境问题的情况下加强医患关系,但如果这让患者感到被评判或操纵,在其他情况下可能会产生相反的效果。因此,我们认为,在同意过程中,没有向所有患者普遍披露环境影响信息的义务。实践绿色生命伦理学的提供者应专注于倡导医疗保健融资、组织和提供方面的系统层面的改变,并在与患者接触时谨慎地提出环境问题。

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