北京某区域重症医学科医生知情同意实践中的伦理困境分析  

Analysis of Ethical Dilemmas in the Practice of Informed Consent of Critical Care Physicians in a Region of Beijing

作　　者：王助衡 孙立平 李玉伟 WANG Zhuheng;SUN Liping;LI Yuwei(Department of Critical Medicine,Daxing Teaching Hospital of Capital Medical University,Beijing 102600,China;Quality Control Center for Critical Care Medicine,Daxing District Health Commission,Beijing 102600,China)

机构地区：[1]首都医科大学大兴教学医院重症医学科,北京102600 [2]北京市大兴区卫健委重症医学质控中心,北京102600

出　　处：《中国医学伦理学》2023年第5期523-527,共5页Chinese Medical Ethics

摘　　要：目的探讨北京某区域重症医学科医生在实践知情同意权过程中所面临的伦理困境。方法采用质性研究的方法,对北京某区域5个医疗机构的14名重症医学科医生进行面对面的深入访谈,将获得资料进行分析,通过编码、归类、提取主题。结果医患沟通中缺乏信任导致知情权被工具化。家属的决定与患者生命健康权相悖时,医生面临选择困境并会对自身带来影响。结论面临这样的伦理困境,建议通过多措施重新构建起医患信任,并对知情同意代理行使作出适当限制。Objective:To explore the ethical dilemmas faced by the critical care physicians in the process of practicing the right to informed consent in a region of Beijing.Methods:14 doctors in the critical care unit from 5 medical institutions in a certain region of Beijing were interviewed in depth face-to-face by qualitative research method.The data obtained were analyzed through coding,classification,and extraction of subjects.Results:The lack of trust in doctor-patient communication leads to the instrumentalization of the right to know.When the decision of family members is inconsistent with the patient's right to life and health,doctors are faced with the dilemma of choice and its impact.Conclusions:Faced with such ethical dilemmas,it is suggested to rebuild doctor-patient trust through multiple measures,and make appropriate restrictions on the agent-executing of the right of informed consent.

关 键 词：重症医学 知情同意权 医患信任 伦理困境 

分 类 号：R-052[医药卫生]