保留还是切除——骨科疾病治疗中的医患共同决策  

Reservation or Excision,Shared Decision-making in Treatment of Some Orthopedics Diseases

作　　者：王君鳌[1] 刘瑜[2] 

机构地区：[1]广东省中医院,广东广州510120 [2]广州中医药大学,广东广州510006

出　　处：《医学与哲学（B）》2017年第1期81-84,共4页Medicine & Philosophy(B)

摘　　要：研究证明医患共同决策能够促进患者参与治疗,增强依从性,从而提高医疗效果。但是上述效果的取得并非仅仅与患者讨论选择治疗方案。部分骨科疾病面临保留修复病患部位或者切除置换病患部位的艰难选择,上述两种方案都涉及各种伦理问题,因而共同决策并不容易。本文认为医患共同决策的有效实施需要医生、患者、医院的共同参与。医生需要意识到技术上最优并不总是对患者最合适,要在了解患者价值观、经济状况等基础上开展知情同意,帮助患者进行决策。而患者也需要具备一定的知识才能更好地决策。因此,医院在其中的角色非常重要,例如对医务人员和患者提供教育培训,从制度上提供支持,如合理的工作负荷、流程、场地等,以促进医患共同决策的有效实施。Studies have shown that shared decision making（SDM）is vital to improve the quality of care service.The efficient SDM involving surgeons,patients and hospitals,it is not just the discussions with patients about the treatment options.Patients who suffer from some orthopedics diseases sometimes have to face tough choices in reconstruction treatment,for both reservation and excision involve ethical dilemmas.Surgeons have to realize that not all the best options in technique are the most suitable options for patients,and perform informed consent base on knowing and understanding patients＇ values of their lives.To facilitate the effectiveness of SDM,the hospital plays a very important role,providing from education for both patients and surgeons to management support.

关 键 词：医生 患者 共同决策 骨科疾病 

分 类 号：R-02[医药卫生]