Conscientious Objection and the Anesthesiologist: An Ethical Dilemma.

IF 9.1 1区医学 Q1 ANESTHESIOLOGY Anesthesiology Pub Date : 2024-11-01 DOI:10.1097/aln.0000000000005173

Raghuram Koganti,Moshe M Cohn,Steven H Resnicoff,Steven Roth

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Abstract

Conscientious objection is a legally protected right of medical professionals to recuse themselves from patient care activities that conflict with their personal values. Anesthesiology is different from most specialties with respect to conscientious objection in that the focus is to facilitate safe, efficient, and successful performance of procedures by others, rather than to perform the treatment in question. This could give rise to a unique, somewhat indirect ethical tension between the application of conscientious objection and potential infringement upon patient autonomy and well-being. While some situations have clear grounds and precedent for conscientious objection (e.g., abortion, or futile procedures), newer procedures, such as gender-affirming surgery and xenotransplantation, may trigger conscientious objection for complex reasons. This review discusses ethical, legal, and practical aspects of conscientious objection; challenges to anesthesia groups, departments, and healthcare organizations when conscientious objection is invoked by anesthesiologists; and strategies to help mitigate the ethical dilemmas.

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良心拒绝与麻醉师：伦理困境。

依良心拒服兵役是受法律保护的医疗专业人员的一项权利，他们有权回避与其个人价值观相冲突的病人护理活动。在依良心拒服兵役方面，麻醉学与大多数专科不同，其重点是促进他人安全、高效、成功地实施手术，而不是实施相关治疗。这可能会在依良心拒服兵役与可能侵犯病人自主权和福祉之间产生一种独特的、有些间接的伦理矛盾。虽然某些情况（如堕胎或徒劳无益的手术）有明确的理由和先例可以出于良心而反对，但较新的手术，如性别确认手术和异种器官移植，可能会出于复杂的原因而引发出于良心的反对。本综述讨论了出于良心拒服兵役的伦理、法律和实践方面的问题；麻醉团体、部门和医疗机构在麻醉医师援引出于良心拒服兵役时面临的挑战；以及帮助缓解伦理困境的策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Anesthesiology 医学-麻醉学

CiteScore

10.40

自引率

5.70%

发文量

542

审稿时长

3-6 weeks

期刊介绍： With its establishment in 1940, Anesthesiology has emerged as a prominent leader in the field of anesthesiology, encompassing perioperative, critical care, and pain medicine. As the esteemed journal of the American Society of Anesthesiologists, Anesthesiology operates independently with full editorial freedom. Its distinguished Editorial Board, comprising renowned professionals from across the globe, drives the advancement of the specialty by presenting innovative research through immediate open access to select articles and granting free access to all published articles after a six-month period. Furthermore, Anesthesiology actively promotes groundbreaking studies through an influential press release program. The journal's unwavering commitment lies in the dissemination of exemplary work that enhances clinical practice and revolutionizes the practice of medicine within our discipline.