癌症坏消息告知中的伦理困境及其对策探讨  

Ethical Dilemma and Its Countermeasures in Cancer Bad News Notification

作　　者：钟瑜琼 王晓敏[2] 刘星 ZHONG Yuqiong;WANG Xiaomin;LIU Xing(School of Public Administration,Central South University,Changsha 410075,China;Center of Clinical Pharmacology/Research Center for Clinical Trial,the Third Xiangya Hospital of Central South University,the Third Xiangya Hospital of Central South University,Changsha 410013,China;Medical Ethics Committee of Xiangya Hospital,Changsha 410008,China;Hospital Mangement Institule,Central South University,Changsha 410008,China)

机构地区：[1]中南大学公共管理学院,湖南长沙410075 [2]中南大学湘雅三医院临床药理中心/临床试验研究中心,湖南长沙410013 [3]中南大学湘雅医院医学伦理委员会,湖南长沙410008 [4]中南大学医院管理研究所,湖南长沙410008

出　　处：《中国医学伦理学》2021年第9期1182-1187,共6页Chinese Medical Ethics

基　　金：中南大学湘雅医院管理研究基金“湖南省出生缺陷防治的伦理指导原则与实施细则”(2021GL13);2021年中南大学教育教学改革研究项目“新文科背景下医学生伦理决策能力培养与提升”(2021jy196)。

摘　　要：在全球范围内,癌症患者诊断和预后告知的问题越来越被关注,然而对于癌症坏消息告知的做法仍没有达成共识。医务人员对于癌症坏消息告知的态度和实践主要受各地社会文化的影响,坏消息告知的方式在国内外也经历了相应变迁,癌症坏消息告知中还充斥着生命健康权与知情同意权的平衡、个人自主与家庭自主的冲突以及风险评估与患者最佳利益权衡的困境等。通过分析癌症坏消息告知中的伦理问题,提出中国应探索符合国情的癌症病情告知技巧、训练沟通模式及加强沟通技能培训等建议。Around the world,more and more attention has been paid to the diagnosis and prognosis notificationof cancer patients,but there is still no consensus on the method of cancer bad news notification.The attitudes and practices of medical staff on cancer bad news notification are mainly influenced by the social culture of different places,the way of cancer bad news notification has also undergone corresponding changes at home and abroad.The process of cancer bad news notification exists problems,such as the balance between the right of life and health and the right to informed consent,the conflict between individual autonomy and family autonomy,and the dilemma between risk assessment and the best interests of patients.This paper analyzed the ethical issues in cancer bad news notification,and proposed that our country should explore cancer notification skills in line with national conditions,train communication mode,and strengthen communication skills training.

关 键 词：癌症 坏消息告知 伦理困境 风险评估 最佳利益权衡 告知技巧 

分 类 号：R-052[医药卫生]