医务社会个案工作的伦理困境分析——基于宁养个案服务的实证研究

Analysis on Ethical Dilemma of Medical Social Case Work:An Empirical Study of Hospice Care

由于中国文化传统、社会工作者的专业能力、社会工作专业价值观与伦理原则四者的冲突,个案工作者在介入晚期癌症患者服务过程中遭遇伦理困境。从社会价值观与专业价值观冲突、社会工作者专业能力不足、社会工作者感情枯竭、角色冲突、保密的程度与情况、案主自决与社会工作者专业知识的冲突六个维度探究个案工作者介入临终关怀服务产生的伦理困境。进而根据实证分析内容,提出保护患者生命健康与提高患者生命质量同等重要,坚持照顾为主、适度治疗的解决对策。

Given the conflicts between traditional Chinese culture and different professional abilities and ethical values, social workers may confront with ethical dilemma when providing health services for terminal cancer patients. This paper explored the ethical dilemma from six dimensions, including conflicts between social values and professional values; incompetence of social workers; emotional exhaustion of social workers; role conflict; confidentiality; conflicts between client self-determination and social workers＇ professional knowledge. According to the empirical analysis, this paper proposed to stress equally on protecting life as well as improving the quality of life, and adhere to the principles of caring and optimized treatment.