出生缺陷新生儿救治相关伦理困境的质性研究  

A qualitative study of ethical dilemmas related to the treatment of newborns with birth defects

作　　者：罗聪[1] 赖灵巧 LUO Cong;LAI Lingqiao(Department of Neonatology,Lishui Central Hospital,Lishui 323000,China)

机构地区：[1]丽水市中心医院新生儿科,浙江丽水323000

出　　处：《中国医学伦理学》2024年第7期759-763,共5页Chinese Medical Ethics

摘　　要：目的 了解出生缺陷新生儿救治相关伦理困境现状,为摆脱伦理困境提供依据。方法 采用质性访谈法对新生儿科13名医护人员进行半结构式深入访谈,采用Nvivo 12.0软件对访谈资料进行编码、分析,提炼相关主题。结果 共提炼出3个主题:出生缺陷新生儿救治相关伦理困境主要包括积极救治与放弃治疗的伦理困境、监护人决策与医护决策的伦理困境;出生缺陷新生儿救治相关伦理困境产生原因与患儿临床病情,主要监护人文化程度、经济水平、价值观,社会经济水平及医疗资源分布等有关;出生缺陷新生儿救治相关伦理困境应对措施包括完善医疗救治体系、形成医患共同决策模式、强化法律法规建设及社会支持。结论 出生缺陷新生儿救治面临多种伦理困境,应采用科学策略摆脱伦理困境。Objective:To understand the current situation of ethical dilemmas related to the treatment of newborns with birth defects,and provide a basis for getting out of ethical dilemmas.Methods:The qualitative interview method was used to conduct semi-structured in-depth interviews with 13 medical staff in neonatology.Nvivo 12.0 software was used for the interview data to code,analyze,and extract relevant themes.Results:A total of three themes were extracted.First,the ethical dilemmas related to the treatment of newborns with birth defects mainly included the ethical dilemma of active treatment and giving up treatment,and the ethical dilemma of guardians’decision-making and medical decision-making.Second,the causes of the ethical dilemmas related to the treatment of newborns with birth defects were related to the clinical conditions of the children,the educational level,the economic level,the values of the main guardians,the socioeconomic level,and the distribution of medical resources.Third,the coping measures for the ethical dilemmas related to the treatment of newborns with birth defects included improving the medical treatment system,forming a joint decision-making model between doctors and patients,and strengthening the construction of laws and regulations and social support.Conclusions:The treatment of newborns with birth defects faced various ethical dilemmas,and scientific strategies should be adopted to get rid of ethical dilemmas.

关 键 词：出生缺陷 新生儿 医患共同决策 伦理困境 

分 类 号：R-052[医药卫生]