关于放弃治疗的伦理思考

在医学伦理学中 ,放弃治疗是一个有争议的社会问题 ,并愈来愈受到人们的关注。本文试图从放弃治疗的类型、放弃治疗的伦理冲突和放弃治疗的伦理准则三个方面 ,对其作一些探讨和研究。     

关于ICU放弃治疗的伦理思考

ICU(重症加强护理病房)放弃治疗的实施有医学伦理学依据,表现为遵循有利原则、尊重患者原则和公平原则.ICU放弃治疗面临的伦理冲突有:因医患价值本位的不同引发的医患冲突、因经济因素引发的患者与家属之间的冲突和因医疗资源引发的生命价值与医疗体制之间的冲突.针对ICU放弃治疗需要加强伦理指导、死亡教育、伦理审查委员会的介入和完善被放弃患者的临终关怀工作.     

非脑死亡患者399例放弃治疗后死亡伦理与法律思考

目的总结399例非脑死亡患者在住院期间放弃治疗后死亡的事例,分析放弃治疗的原因、放弃治疗涉及医学、伦理、法律和社会保障等问题。方法重审我院2007—2008年死亡的病历,将放弃治疗后死亡的病历分类分析统计。结论病情恶化、病程不可逆转是放弃治疗的主要原因。医生应该尽告知义务．要尊重患者生命权、健康权、知情权、选择权、决定权和隐私权。医生没有放弃治疗的权利。患者和家属应该签署“放弃治疗”的医学文书,以示对“放弃”负责和承担相关后果。在法律的基础上,弘扬我国社会和谐,人文道德,医学伦理。     

放弃治疗与安乐死的伦理争论

放弃治疗与安乐死是医学伦理学界争论的一个重要伦理问题,争论的问题包括放弃治疗与安乐死的伦理意义、标准与对象界定、赞成与反对的伦理争论、安乐死的立法、及医学与法律基本程序,本文从不同的视角较为全面地阐述了上述问题,并做了充分的解释和说明.     

ICU终末期患者放弃治疗的伦理思考

对ICU终末期放弃治疗患者进行概述,明确终末期放弃治疗的定义,从伦理角度分析ICU终末期患者放弃治疗存在的问题,针对特定问题,提出可行对策。     

论恶性肿瘤患者的放弃治疗——消极安乐死

在临床工作中,恶性肿瘤患者确诊后放弃治疗的现象极为常见,对恶性肿瘤患者放弃治疗其实就是一种消极的、被动的安乐死,是严重违背我们的社会伦理准则和医学宗旨的,通过分析其原因,对解决办法进行了初步的探讨。     

喉癌患者主动放弃治疗的伦理学初探

经济困难仍是喉癌患者放弃治疗的主要问题,部分全身情况较好的患者不应过早放弃治疗,应尽力救治。误诊漏诊导致病变由可治变为不可治的放弃治疗要尽量避免。医师具有高度的责任心,精湛的医术,重视多学科协作及综合治疗,是喉癌治疗取得良好效果的保证。对喉癌患者放弃治疗的决策,经济因素不应是主要的。人们完全能够在尊重科学和理性、尊重生命末期价值和意义以及追求社会资源公正分配和有效利用基础上达成共识。医疗卫生服务的基本目标是社会公众利益的最大化,这是医疗卫生服务领域中始终应占主导地位的价值取向,当然也是医改中政府责任伦理的正确取向。     

关于心胸重症监护病房的伦理思考

心胸重症监护病房（Cardiothoracic Intensive Care Uint,CTICU）是集中收治危重心肺血管疾病病人的场所。在CTICU中 ，由于拥有技术精良的医护人员和先进的 仪器设备，因此许多经历危险和复杂收心肺手术的病人，甚至一些垂死的病人均能获得及时精心的治疗和加强监护而收到良好的效果。然而当我们从CTICU获益的同时，又经常面临一些伦理的挑战，其中，与CTICU中高新技术应用和放弃治疗或手术有关的 伦理冲突具有代表性。本文将根据CTICU的临床特点讨论有关 的伦理冲突和伦理准则。     

重型颅脑损伤患者放弃治疗的伦理思考

通过从生命质量与价值、经济伦理学、医学与权责等方面的考量与讨论,建议重型颅脑损伤患者的放弃治疗在其治疗的不同阶段应区别对待,遵循一定的伦理准则,并完善相关政策法规。     

高压氧治疗对脑瘫患儿的伦理思考

脑瘫康复是一个漫长而艰巨的过程,在早期综合治疗的基础上配合高压氧(HBO)治疗使效果显著,但由于HBO疗程长,代价大,需要长期坚持治疗,给家庭和社会带来了沉重的负担,导致部分家长放弃治疗,这就给护理工作提出了一系列的伦理思考。     

试论职业卫生的伦理建设

职业病危害已成为涉及国计民生的一个重大公共卫生问题。从医学伦理的角度，分析当前我国职业病防治工作中存在的伦理问题，剖析了产生问题的伦理原因，同时提出了对职业病防治工作伦理建设的构想。     

异性医患诊治的伦理探讨

性别伦理研究和教育的缺失、医院对异性医患诊治伦理问题的忽视、部分医务人员异性医患诊治伦理意识的淡漠导致了异性医患诊治伦理问题长期存在。对此提出建议：加强异性医患诊治伦理方面的理论研究;加强医学生和医务人员异性医患诊治伦理的教育和继续教育;医疗机构要重视异性医患诊治伦理的实践;医务人员要重视自身伦理素养的提升。     

How tall is too tall? On the ethics of oestrogen treatment for tall girls

Oestrogen treatment for girls, to prevent psychosocial problems due to extreme tallness, has been available for almost 50 years but uncertainty about its position prevails. The ethical problems of this treatment are focused on in this paper. After a brief overview on historical and medical aspects, ethical issues such as the general justification of oestrogen treatment, evaluation of its success and ethical concerns related to research in this subject are dealt with in detail.     

When doctors disagree

During a discussion of problem cases a disagreement over treatment turns out to have deeper and more diverse ethical problems which threaten a partnership and reveal unresolved tensions in a family. The case was presented by a young general practitioner to a group at a postgraduate meeting.     

Ethical dilemmas in occupational therapy and physical therapy: a survey of practitioners in the UK National Health Service.

OBJECTIVES: To identify ethical dilemmas experienced by occupational and physical therapists working in the UK National Health Service (NHS). To compare ethical contexts, themes and principles across the two groups. DESIGN: A structured questionnaire was circulated to the managers of occupational and physical therapy services in England and Wales. SUBJECTS: The questionnaires were given to 238 occupational and 249 physical therapists who conformed to set criteria. RESULTS: Ethical dilemmas experienced during the previous six months were reported by 118 occupational and 107 physical therapists. The two groups were similar in age, grade, and years of experience. Fifty of the occupational therapy dilemmas occurred in mental health settings but no equivalent setting emerged for physical therapy. Different ethical themes emerged between the two groups, with the most common in occupational therapy being difficult/dangerous behaviour in patients and unprofessional staff behaviour, and for physical therapists resource limitations and treatment effectiveness. No differences were found in the ethical principles used. CONCLUSION: The ethical dilemmas reported by the therapists were primarily concerned with health care ethics, rather than the more dramatic ethics reported in much of the biomedical ethics literature. Differences were found between the two professional groups when ethical contexts and themes were compared but not when ethical principles were compared. This suggests that educators and researchers need to be aware of work settings and the interdisciplinary nature of employment as well as ethical principles held by individual therapists.     

How medical ethical principles are applied in treatment with artificial insemination by donors (AID) in Hunan, China: effective practice at the Reproductive and Genetic Hospital of CITIC-Xiangya

This paper investigates the efficiency of application of medical ethics principles in the practice of artificial insemination by donors (AID) in China, in a culture characterised by traditional ethical values and disapproval of AID. The paper presents the ethical approach to AID treatment as established by the Reproduction and Genetics Hospital of CITIC-Xiangya (CITIC Hunan-Yale Approach) in the central southern area of China against the social ethical background of China and describes its general features. The CITIC-Xiangya Approach facilitates the implementation of ethical relations between clinicians and patients participating in AID treatment procedures in Hunan-Yale.     

Distinguishing treatment from research: a functional approach

The best way to distinguish treatment from research is by their functions. This mode of distinction fits well with the basic ethical work that needs to be carried out. The distinction needs to serve as an ethical flag, highlighting areas in which the goals of doctors and patients are more likely than usual to diverge. The distinction also allows us to illuminate and understand some otherwise puzzling elements of debates on research ethics: it shows the peculiarity of exclusive conceptions of the distinction between research and treatment; it allows us to frame questions about therapeutic obligations in the research context, and it allows us to consider whether there may be research obligations in the therapeutic context.     

行业伦理教育对报考心理咨询师人员双重关系伦理意识的影响

目的了解行业伦理培训对参加心理咨询培训人员在双重关系伦理意识方面的影响。方法采用问卷调查法和实验干预的办法,以自编“心理咨询和治疗伦理问题调查问卷（参加心理咨询师培训人员版）”作为评价工具,对广东范围内368名参加心理咨询师培训人员进行调查,其中203人没有接受行业伦理培训的课程,在本研究中设为1组;161人接受了行业伦理教育的课程,在本研究中设为2组。结果两组人员相比较,在涉及双重关系伦理意识的判定上,第2组选择“不清楚”人数比例与第1组相比。大部分条目上都出现了不同程度的下降。两组人员在有关双重关系伦理意识的判断上共有10个条目一致度（选择“不符合”者）分别都达到了80％及以上。两组人员在9个有关非性的双重关系的条目上在作出伦理意识的判断时都表现出了很大的争议;两组人员在5个关于非性的双重关系伦理意识条目的判断上表现出显著差异（P〈0．05）。结论对参加心理咨询师培训的人员进行行业伦理教育,能够帮助他们在双重关系方面树立起比较清晰的行业伦理意识;在对参加心理咨询师培训人员进行有关双重关系的行业伦理教育时,要注意有关非性双重关系伦理意识的本土特点;本研究有一定的局限性,参加心理咨询培训人员应该接受系统全面的行业伦理教育。