Sadooghiasl Afsaneh, Khaleghparast Shiva, Shamsi Gooshki Ehsan
Assistant Professor, Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran; MSc Student in Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. Visiting researcher, Institute for Ethics and History of Health in Society, Augsburg University, Augsburg, Germany.
Associate Professor, Cardiovascular Nursing Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
J Med Ethics Hist Med. 2024 Dec 23;17:14. doi: 10.18502/jmehm.v17i14.18666. eCollection 2024.
Refusal of treatment is a challenging issue in clinical ethics, especially in the context of pregnancy care. However, respect for patient autonomy remains a fundamental ethical principle, as outlined in codes of conduct and patient rights within healthcare services. The aim of this case presentation was to critically analyze a clinical ethics case within the Iranian context using an ethical framework. A theory-based framework was used that integrates the principlism approach, based on prima facie moral norms, with the moral development theories of Lawrence Kohlberg and James Rest to analyze this case. Mrs. M, a 38-year-old pregnant woman with acute myeloid leukemia, chose to continue her pregnancy until 32 weeks, despite medical advice, before starting her cancer treatment.
拒绝治疗是临床伦理中一个具有挑战性的问题，尤其是在孕期护理的背景下。然而，正如医疗服务中的行为准则和患者权利所概述的那样，尊重患者自主权仍然是一项基本的伦理原则。本病例报告的目的是使用一个伦理框架对伊朗背景下的一个临床伦理案例进行批判性分析。我们使用了一个基于理论的框架，该框架将基于初步道德规范的原则主义方法与劳伦斯·科尔伯格和詹姆斯·雷斯特的道德发展理论相结合来分析此案例。M夫人是一名38岁的急性髓性白血病孕妇，尽管有医学建议，她仍选择在开始癌症治疗前继续妊娠至32周。
