从自主性角度探讨胎儿新生儿医学伦理问题

Discussing Medical Ethical Issues in Fetal Neonatal Patients From the Perspective of Autonomy

随着医疗技术的发展,越来越多过去认为不可能治疗的胎儿新生儿疾病出现了可行的治疗方案,但同时也带来了一系列复杂的伦理问题,最主要的问题就是如何更加科学进行胎儿新生儿患儿的临床决策。医学伦理学是运用普通规范伦理学的理论和原则来解决医学实践和医学科学发展中人们相互之间、医学团体与社会之间道德关系而形成的一门学科,它的四个基本原则是自主性、有益、无害和公正,文章主要以伦理学基本原则之一的自主性为出发点,从医方和患方两个角度,提出了实际存在的一些问题,并初步探讨了可能的解决方法,包括建立合理的临床决策系统,伦理委员会的介入,以及社会第三方福利机构的介入等。以期形成一个更加全面、更加科学的解决胎儿新生儿临床伦理问题的临床可操作流程。

With the development of medical technology,more and more fetal and newborn diseases that were considered impossible to treat in the past have emerged as feasible treatment options,but at the same time they also bring a series of complex ethical problems,and the most important question is how to make clinical decisions in fetal and neonatal patients more scientifically.Medical ethics is a subject which is formed by applying the theories and principles of general normative ethics to solve the moral relations between people in medical practice and the development of medical science and between the medical community and the society,and its basic principles are autonomy,benefit,harmlessness and justice.Based on the autonomy of one of the basic principles of ethics,this paper puts forward some practical problems from the perspective of both the medical side and the patient,and discusses the possible solutions,including the establishment of a reasonable clinical decision-making system,the intervention of the ethics committee,and the intervention of the social third-party welfare institutions,in order to form a more comprehensive and more scientific solution to the clinical ethics of fetal neonatal issue.