察觉、辨析、体验,让医学伦理遍布临床

Perception,Differentiation and Experience:Approaches for Medical Ethics Percolating into Clinical Practice

临床医学伦理有两条进路:外部渗入与内部自生。前者因有伦理规范和相关法律约束,已初步得到落实,后者则是常寓于医疗实践中的常态,难有规范约束,且有背离初衷之事例发生。诸如诊疗方案、新技术的应用、手术、急诊救治、护理等临床实践中的伦理问题,需要通过察觉、辨析、体验的进路才能得以彰显和重视。而坚持医生临床、构建医患间的权力平衡、重视非技术因素在医疗中的作用,启动医师美德的动力机制,则是保证医学伦理遍布临床的重要支撑条件。

There are two paths in clinical medical ethics:external percolation and internal self-development.The former has been preliminarily implemented because of ethical norms and related legal constraints,while the latter is not because it is the norm in medical practice,it is difficult to have norms and constraints,and there are instances of deviation from the original intention.The ethical issues in clinical practice,such as diagnosis and treatment plans,application of new technologies,operation,emergency treatment,nursing etc.,need to be manifested and paid attention to through the approach of perception,differentiation and experience.Clinical practice,balanced-power between doctors and patients,attention to the role of non-technical factors in medical treatment,and the dynamic mechanism of doctors'virtues are important supporting conditions to ensure medical ethics percolate into clinical practice.