Kogetsu Atsushi, Koimizu Jungen
Department of Biomedical Ethics and Public Policy, Graduate School of Medicine, Osaka University, Osaka, Japan.
Department of Plastic and Reconstructive Surgery, Japanese Red Cross Society Kyoto Daini Hospital, Kyoto, Japan.
Asian Bioeth Rev. 2024 Aug 15;17(1):91-99. doi: 10.1007/s41649-024-00302-8. eCollection 2025 Jan.
In recent years, the global need for clinical ethics consultation services (CECS) has increased to address ethical challenges, dilemmas, and moral distress in clinical environments. In Japan, many hospitals have introduced CECS over the past decade, but few such services work effectively because of the small number of consultations. To address this, we propose two proactive ethics consultation methods: inter-professional ethics rounds and patient note reviews. This paper provides a detailed explanation of these methods, complete with scenarios based on actual cases. These methods can make CECS 'well-functioning' by shifting the starting points of consultation from consultees to CECS providers. We then examine the impact and value of proactive ethics consultation as well as four critical factors for its success including attitude, positioning, and competency of proactive consultation teams. We believe our suggestions will provide valuable insights for future clinical ethics consultations and stimulate academic debate about what constitutes a 'well-functioning' CECS.
近年来，全球对临床伦理咨询服务（CECS）的需求不断增加，以应对临床环境中的伦理挑战、困境和道德困扰。在日本，许多医院在过去十年中引入了CECS，但由于咨询数量较少，很少有此类服务能有效运作。为了解决这一问题，我们提出了两种积极主动的伦理咨询方法：跨专业伦理查房和病历审查。本文详细解释了这些方法，并配有基于实际案例的场景。这些方法可以通过将咨询的起点从被咨询者转移到CECS提供者，使CECS“有效运作”。然后，我们研究了积极主动的伦理咨询的影响和价值，以及其成功的四个关键因素，包括积极主动咨询团队的态度、定位和能力。我们相信我们的建议将为未来的临床伦理咨询提供有价值的见解，并激发关于什么构成“有效运作”的CECS的学术辩论。
