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产前诊断临床伦理咨询的现状与挑战:中国委员会工作人员视角的质性研究

The Current State and Challenges of Clinical Ethics Consultation for Prenatal Diagnosis: A Qualitative Study of Committee Employee Perspectives in China.

作者信息

Wu Ying, Hao Tianchi, Liu Xing, Zhang Xin, Zhong Yuqiong, Luo Dan, Wang Xiaomin

机构信息

School of Humanities, Central South University, Changsha, Hunan China.

Medical Ethics Committee, Xiangya Hospital of Central South University, Changsha, Hunan China.

出版信息

Asian Bioeth Rev. 2024 Sep 5;17(1):73-90. doi: 10.1007/s41649-024-00303-7. eCollection 2025 Jan.

Abstract

Clinical ethics consultations (CECs) play an important role in resolving ethical issues in clinical practice worldwide. The government has encouraged the development of CECs in China to address the ethical challenges arising in prenatal diagnosis. So far, the current state and challenges facing CEC remain understudied. This study aimed to explore the perspectives of employees on ethics committees for prenatal diagnosis in 13 medical institutions in Hunan Province, China. Twenty-eight employees participated in interviews. Our qualitative approach employed content analysis to identify major themes in interviewees' responses, which covered the composition and vision of their prenatal diagnosis ethics committee, as well as the challenges they faced. The results show that CEC in China is in an exploratory stage, with models for CEC composition, and workflow varying significantly. Therefore, we propose the future direction of efforts to improve CECs, including improving CEC working mechanisms and operating procedures, strengthening ethical training for healthcare workers and ethics committee employees, and developing more specific ethical guidance based on the accumulated experiences of ethics committee employees in the early development of CEC for prenatal diagnosis.

摘要

临床伦理会诊(CECs)在全球范围内解决临床实践中的伦理问题方面发挥着重要作用。中国政府鼓励发展临床伦理会诊,以应对产前诊断中出现的伦理挑战。到目前为止,临床伦理会诊的现状和面临的挑战仍未得到充分研究。本研究旨在探讨中国湖南省13家医疗机构中员工对产前诊断伦理委员会的看法。28名员工参与了访谈。我们采用定性研究方法,通过内容分析来确定受访者回答中的主要主题,这些主题涵盖了他们产前诊断伦理委员会的组成和愿景,以及他们面临的挑战。结果表明,中国的临床伦理会诊正处于探索阶段,临床伦理会诊的组成模式和工作流程差异很大。因此,我们提出了改进临床伦理会诊的未来努力方向,包括完善临床伦理会诊工作机制和操作程序,加强对医护人员和伦理委员会员工的伦理培训,以及根据伦理委员会员工在产前诊断临床伦理会诊早期发展中的积累经验制定更具体的伦理指导。

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