难治性精神疾病立体定向神经调控治疗的伦理风险及其防治

Ethical Risks and Prevention of the Treatment for Refractory Mental Disorders with Stereotactic Neuroregulation

难治性精神疾病立体定向神经调控治疗技术的伦理风险主要包括精神疾病的病因理论不确定性风险、多元的行动主体责任归属风险、主体权利认定风险适应证、禁忌证范围认定及知情同意权的认定风险以及分配公平公正风险。临床实践中病因理论的确定性不断被证实、临床实践诊疗程序逐步规范、知情同意权日益明确,难治性精神疾病立体定向神经调控治疗技术伦理风险逐步得到改善。提出通过政府加大宣传力度,增强公众的认知水平;明确各级组织的管理职责,分工协作调配资源,完善服务模式;加强相关领域制度建设与落实等防治路径来规避难治性精神疾病立体定向神经调控治疗技术的伦理风险。

The ethical risks of stereotactic neuroregulation therapy for refractory mental disorders mainly include the uncertainties in the etiological theories of mental disorders,the attribution of responsibility among diverse stakeholders,the recognition of subject rights and the determination of indications and contraindications,and risks in determining the right to informed consent,as well as risks of fair distribution.In clinical practice in China,the certainty of etiological theories is continuously being verified,diagnostic and therapeutic procedures are becoming more standardized,and the rights of informed consent are increasingly clarified,leading to gradual improvement in the ethical risks associated with this therapy.To mitigate these ethical risks,it is proposed to enhance public awareness through increased governmental promotion,clarify the management responsibilities at various organizational levels to coordinate resource allocation,and improve service models,as well as strengthen the construction and implementation of relevant institutional frameworks.