高龄老年患者临床诊治过程中的伦理思考  

Ethical Reflections on the Clinical Diagnosis and Treatment of Elderly Patients

作　　者：黄樱硕[1] 尹航[1] 李悦[2] 崔焱[2] 李虹伟[3] HUANG Yingshuo;YIN Hang;LI Yue;CUI Yan;LI Hongwei(Research Ward,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Bioethics Committee,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Department of Geriatrics,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院研究型病房,北京100050 [2]首都医科大学附属北京友谊医院生命伦理委员会,北京100050 [3]首都医科大学附属北京友谊医院医疗保健中心,北京100050

出　　处：《中国医学伦理学》2019年第5期612-615,共4页Chinese Medical Ethics

基　　金：北京市优秀人才青年骨干项目基金(2014000021469G265);首都医科大学附属北京友谊医院科研启动基金(yyqdkt2015-26)资助

摘　　要：高龄老年患者具有以慢性疾病为主,合并疾病多,病程长,病情及用药复杂等特点,在临床诊治过程中,常见的伦理问题主要体现在高龄老年患者知情同意及临床决策存在很大难度。其中既有家属的原因,也有医护人员及社会因素的影响。在结合临床实例就上述现象进行分析的基础上,结合舒缓医学的理念进行讨论,提出如下建议:尊重患者本人决定,遵守法律及伦理要求;明确唯一委托人;提高医护人员的沟通能力;提高医护人员对舒缓医学的认识;实施分级诊疗照护,加强康复训练和人文关怀。The elderly patients are characterized by chronic diseases, many complications, long course of disease, complicated condition and medication.In the process of clinical diagnosis and treatment, the common ethical problems are mainly reflected in the difficulty of informed consent and clinical decision-making of elderly patients. There are not only family reasons, but also medical staff and social factors. Based on the analysis of the above phenomena and the concept of palliative medicine, the following suggestions were put forward: respecting the elderly patient s decision, abiding by the legal and ethical requirements;defining the sole client;improving the communication ability of medical staff;improving the understanding of palliative care of medical staff;implementing graded diagnosis and treatment care, strengthening rehabilitation training and humanistic care.

关 键 词：老年医学 高龄老年患者 知情同意 舒缓医学 

分 类 号：R-052[医药卫生]