Williamson P, McCormick T, Taylor T
J Fam Pract. 1983 Dec;17(6):1039-43.
This article presents a family case study of a recurrent dilemma in family medicine. The ethical dilemma involves what role the physician should play in mediating a conflict in a family when the health needs and wishes of the individual patient do not parallel those of the other family members. Who is the patient, the individual or the family? It is the authors' conviction that in meeting the needs of the presenting patient, the family context is of great importance. To this end, the authors delineate a framework for analyzing ethical conflicts of this nature, utilizing key ethical principles in combination with a systems perspective to aid in the clarification of such choices. The principles examined include autonomy, nonmaleficence, and justice. Also taken into account are the relevant facts, values, and the biases of the physician. Exploration of these factors allows the physician a comprehensive and logical approach for resolving such conflicts. Such a framework, however, can only provide guidance; it does not guarantee easy or uniformly acceptable alternatives to difficult issues.
本文呈现了一个家庭医学中反复出现的两难困境的家庭案例研究。这种伦理困境涉及当个体患者的健康需求和愿望与其他家庭成员的需求和愿望不一致时，医生在调解家庭冲突中应扮演何种角色。患者是谁，是个体还是家庭？作者坚信，在满足前来就诊患者的需求时，家庭背景至关重要。为此，作者勾勒了一个分析此类性质伦理冲突的框架，运用关键伦理原则并结合系统视角来帮助厘清此类选择。所审视的原则包括自主性、不伤害和公正。同时也考虑了相关事实、价值观以及医生的偏见。对这些因素的探究使医生能够采用全面且合乎逻辑的方法来解决此类冲突。然而，这样一个框架只能提供指导；它并不能保证为难题提供轻松或一致可接受的解决方案。
